How much rates vary
Facilitymedian $1,862 · 10th to 90th $661 to $8,710Professionalmedian $437 · 10th to 90th $81 to $724
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $954.99 Median $6,918.31 Typical High $12,022.64 | Facility | None | $954.99 | $6,918.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $5,754.40 | Professional | None | $524.81 | $524.81 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $7,585.78 | Facility | None | $630.96 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $831.76 | Professional | None | $416.87 | $512.86 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $776.25 Typical High $1,230.27 | Professional | 50 · Both sides | $616.60 | $776.25 | $1,230.27 |
Aultcare Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $1,513.56 Typical High $1,995.26 | Facility | None | $676.08 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,737.80 Typical High $2,691.53 | Facility | None | $562.34 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,023.29 | Professional | None | $549.54 | $691.83 | $1,023.29 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,023.29 | Professional | None | $549.54 | $691.83 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $338.84 Typical High $616.60 | Professional | None | $70.79 | $338.84 | $616.60 |
SummaCare Setting Facility Modifier None Typical Low $851.14 Median $891.25 Typical High $1,000.00 | Facility | None | $851.14 | $891.25 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $691.83 | Professional | None | $478.63 | $524.81 | $691.83 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $346.74 Median $575.44 Typical High $1,000.00 | Professional | None | $346.74 | $575.44 | $1,000.00 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $263.03 Typical High $977.24 | Professional | 52 · Reduced service | $263.03 | $263.03 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $389.05 | Professional | 53 · Discontinued | $104.71 | $104.71 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $1,479.11 | Professional | 54 · Surgery only | $389.05 | $389.05 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $295.12 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $194.98 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $1,380.38 |
Where Ohio sits
The same service costs 5.3 times more in Oklahoma than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
OK $9,157MT $1,742
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.