How much rates vary
Facilitymedian $631 · 10th to 90th $182 to $4,365Professionalmedian $186 · 10th to 90th $43 to $316
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 $354.81 Median $2,691.53 Typical High $10,964.78 | Facility | None | $354.81 | $2,691.53 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $446.68 | Professional | None | $114.82 | $186.21 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $851.14 Typical High $3,388.44 | Facility | None | $389.05 | $851.14 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $173.78 | Professional | None | $74.13 | $87.10 | $173.78 |
Aultcare Setting Professional Modifier None Typical Low $144.54 Median $269.15 Typical High $269.15 | Professional | None | $144.54 | $269.15 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $154.88 Median $162.18 Typical High $199.53 | Facility | None | $154.88 | $162.18 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $288.40 Typical High $1,479.11 | Facility | None | $162.18 | $288.40 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $245.47 Typical High $363.08 | Professional | None | $134.90 | $245.47 | $363.08 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $162.18 Median $288.40 Typical High $1,479.11 | Facility | None | $162.18 | $288.40 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $316.23 | Professional | None | $144.54 | $208.93 | $316.23 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $190.55 Typical High $316.23 | Professional | None | $30.20 | $190.55 | $316.23 |
SummaCare Setting Facility Modifier None Typical Low $87.10 Median $91.20 Typical High $102.33 | Facility | None | $87.10 | $91.20 | $102.33 |
SummaCare Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $275.42 | Professional | None | $128.82 | $190.55 | $275.42 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,311.31 | Facility | None | $363.08 | $691.83 | $3,311.31 |
United Setting Professional Modifier None Typical Low $102.33 Median $181.97 Typical High $363.08 | Professional | None | $102.33 | $181.97 | $363.08 |
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 $64.57 Median $112.20 Typical High $123.03 | Professional | 52 · Reduced service | $64.57 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $44.67 Typical High $48.98 | Professional | 53 · Discontinued | $25.70 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $169.82 Typical High $186.21 | Professional | 54 · Surgery only | $95.50 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $33.88 Typical High $37.15 | Professional | 55 · Aftercare only | $19.05 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $22.39 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.88 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $158.49 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $89.13 | $158.49 | $173.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $109.65 Median $128.82 Typical High $263.03 | Professional | 50 · Both sides | $109.65 | $128.82 | $263.03 |
Where Ohio sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 46th of 51
$191
AK $617KY $170
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.