How much rates vary
Facilitymedian $1,820 · 10th to 90th $562 to $7,586Professionalmedian $245 · 10th to 90th $48 to $457
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 $707.95 Median $4,365.16 Typical High $12,589.25 | Facility | None | $707.95 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $1,148.15 | Professional | None | $229.09 | $346.74 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $7,585.78 | Facility | None | $588.84 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $316.23 | Professional | None | $141.25 | $165.96 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $1,513.56 Typical High $1,995.26 | Facility | None | $288.40 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,698.24 Typical High $2,511.89 | Facility | None | $489.78 | $1,698.24 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $549.54 | Professional | None | $234.42 | $371.54 | $549.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,737.80 Typical High $2,454.71 | Facility | None | $512.86 | $1,737.80 | $2,454.71 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $549.54 | Professional | None | $234.42 | $371.54 | $549.54 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $223.87 Typical High $398.11 | Professional | None | $33.88 | $223.87 | $398.11 |
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 $223.87 Median $295.12 Typical High $416.87 | Professional | None | $223.87 | $295.12 | $416.87 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $562.34 | Professional | None | $181.97 | $309.03 | $562.34 |
7 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 $112.20 Median $173.78 Typical High $186.21 | Professional | 52 · Reduced service | $112.20 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $69.18 Typical High $74.13 | Professional | 53 · Discontinued | $45.71 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $257.04 Typical High $281.84 | Professional | 54 · Surgery only | $169.82 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $51.29 Typical High $56.23 | Professional | 55 · Aftercare only | $33.88 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $34.67 Typical High $37.15 | Professional | 56 · Pre-op care only | $22.91 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $239.88 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $158.49 | $239.88 | $263.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $213.80 Median $251.19 Typical High $467.74 | Professional | 50 · Both sides | $213.80 | $251.19 | $467.74 |
Where Ohio sits
The same service costs 5.5 times more in Alaska than in Texas. 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
$257
AK $1,202TX $219
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.