How much rates vary
Facilitymedian $1,047 · 10th to 90th $537 to $7,244Professionalmedian $245 · 10th to 90th $52 to $407
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 $501.19 Median $1,047.13 Typical High $10,964.78 | Facility | None | $501.19 | $1,047.13 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $269.15 Typical High $831.76 | Professional | None | $251.19 | $269.15 | $831.76 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,174.90 Typical High $4,786.30 | Facility | None | $562.34 | $1,174.90 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $371.54 | Professional | None | $162.18 | $190.55 | $371.54 |
Aultcare Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $812.83 Typical High $1,047.13 | Facility | None | $346.74 | $812.83 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $933.25 Typical High $2,398.83 | Facility | None | $549.54 | $933.25 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $537.03 | Professional | None | $281.84 | $354.81 | $537.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $933.25 Typical High $2,398.83 | Facility | None | $602.56 | $933.25 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $141.25 Median $316.23 Typical High $467.74 | Professional | None | $141.25 | $316.23 | $467.74 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $194.98 Typical High $354.81 | Professional | None | $33.88 | $194.98 | $354.81 |
SummaCare Setting Facility Modifier None Typical Low $446.68 Median $467.74 Typical High $537.03 | Facility | None | $446.68 | $467.74 | $537.03 |
SummaCare Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $380.19 | Professional | None | $269.15 | $323.59 | $380.19 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $5,888.44 | Facility | None | $691.83 | $1,445.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $194.98 Median $331.13 Typical High $537.03 | Professional | None | $194.98 | $331.13 | $537.03 |
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 $134.90 Median $151.36 Typical High $162.18 | Professional | 52 · Reduced service | $134.90 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $60.26 Typical High $64.57 | Professional | 53 · Discontinued | $53.70 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $229.09 Typical High $245.47 | Professional | 54 · Surgery only | $204.17 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $40.74 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.20 Typical High $32.36 | Professional | 56 · Pre-op care only | $26.92 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $213.80 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $190.55 | $213.80 | $229.09 |
Where Ohio sits
The same service costs 6.8 times more in Alaska than in Utah. 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.
Ohio· 49th of 51
$251
AK $1,288UT $191
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.