How much rates vary
Facilitymedian $1,023 · 10th to 90th $309 to $5,754Professionalmedian $288 · 10th to 90th $46 to $537
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 $758.58 Median $2,691.53 Typical High $10,964.78 | Facility | None | $758.58 | $2,691.53 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $912.01 | Professional | None | $251.19 | $331.13 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,148.15 Typical High $4,570.88 | Facility | None | $524.81 | $1,148.15 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $380.19 | Professional | None | $169.82 | $199.53 | $380.19 |
CareSource Setting Facility Modifier None Typical Low $257.04 Median $331.13 Typical High $354.81 | Facility | None | $257.04 | $331.13 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $446.68 Typical High $2,398.83 | Facility | None | $263.03 | $446.68 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $645.65 | Professional | None | $281.84 | $426.58 | $645.65 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $263.03 Median $446.68 Typical High $2,398.83 | Facility | None | $263.03 | $446.68 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $645.65 | Professional | None | $281.84 | $426.58 | $645.65 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $165.96 Typical High $467.74 | Professional | None | $31.62 | $165.96 | $467.74 |
SummaCare Setting Facility Modifier None Typical Low $141.25 Median $147.91 Typical High $169.82 | Facility | None | $141.25 | $147.91 | $169.82 |
SummaCare Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $501.19 | Professional | None | $275.42 | $354.81 | $501.19 |
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 $218.78 Median $363.08 Typical High $630.96 | Professional | None | $218.78 | $363.08 | $630.96 |
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 $138.04 Median $204.17 Typical High $218.78 | Professional | 52 · Reduced service | $138.04 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $81.28 Typical High $87.10 | Professional | 53 · Discontinued | $54.95 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $309.03 Typical High $331.13 | Professional | 54 · Surgery only | $208.93 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $41.69 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $40.74 Typical High $43.65 | Professional | 56 · Pre-op care only | $27.54 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $288.40 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $194.98 | $288.40 | $309.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $251.19 Median $295.12 Typical High $562.34 | Professional | 50 · Both sides | $251.19 | $295.12 | $562.34 |
Where Ohio sits
The same service costs 4.7 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
$302
AK $1,175UT $251
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.