How much rates vary
Facilitymedian $1,023 · 10th to 90th $501 to $4,786Professionalmedian $331 · 10th to 90th $54 to $575
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 $549.54 Median $1,548.82 Typical High $10,715.19 | Facility | None | $549.54 | $1,548.82 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $954.99 | Professional | None | $275.42 | $363.08 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,148.15 Typical High $4,466.84 | Facility | None | $524.81 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $407.38 | Professional | None | $177.83 | $208.93 | $407.38 |
Aultcare Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $691.83 Typical High $891.25 | Facility | None | $380.19 | $691.83 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $794.33 Typical High $1,995.26 | Facility | None | $489.78 | $794.33 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $676.08 | Professional | None | $316.23 | $467.74 | $676.08 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $794.33 Typical High $1,995.26 | Facility | None | $512.86 | $794.33 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $676.08 | Professional | None | $316.23 | $467.74 | $676.08 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $295.12 Typical High $549.54 | Professional | None | $33.88 | $295.12 | $549.54 |
SummaCare Setting Facility Modifier None Typical Low $380.19 Median $398.11 Typical High $457.09 | Facility | None | $380.19 | $398.11 | $457.09 |
SummaCare Setting Professional Modifier None Typical Low $295.12 Median $389.05 Typical High $537.03 | Professional | None | $295.12 | $389.05 | $537.03 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $691.83 | Professional | None | $245.47 | $389.05 | $691.83 |
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 $151.36 Median $218.78 Typical High $234.42 | Professional | 52 · Reduced service | $151.36 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $87.10 Typical High $93.33 | Professional | 53 · Discontinued | $60.26 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $323.59 Typical High $346.74 | Professional | 54 · Surgery only | $223.87 | $323.59 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $64.57 Typical High $69.18 | Professional | 55 · Aftercare only | $44.67 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $43.65 Typical High $46.77 | Professional | 56 · Pre-op care only | $30.20 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $302.00 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $208.93 | $302.00 | $323.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $316.23 Typical High $602.56 | Professional | 50 · Both sides | $269.15 | $316.23 | $602.56 |
Where Ohio sits
The same service costs 4.9 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· 48th of 51
$347
AK $1,413UT $288
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.