How much rates vary
Facilitymedian $1,862 · 10th to 90th $724 to $8,913Professionalmedian $501 · 10th to 90th $95 to $832
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 $912.01 Median $8,128.31 Typical High $13,803.84 | Facility | None | $912.01 | $8,128.31 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $2,137.96 | Professional | None | $467.74 | $630.96 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,737.80 Typical High $7,762.47 | Facility | None | $707.95 | $1,737.80 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $645.65 | Professional | None | $288.40 | $338.84 | $645.65 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $1,995.26 | Facility | None | $602.56 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,737.80 Typical High $3,019.95 | Facility | None | $724.44 | $1,737.80 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $1,023.29 | Professional | None | $501.19 | $660.69 | $1,023.29 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $1,737.80 Typical High $2,951.21 | Facility | None | $741.31 | $1,737.80 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $1,023.29 | Professional | None | $501.19 | $660.69 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $436.52 Typical High $794.33 | Professional | None | $70.79 | $436.52 | $794.33 |
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 $457.09 Median $602.56 Typical High $758.58 | Professional | None | $457.09 | $602.56 | $758.58 |
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 $380.19 Median $602.56 Typical High $1,047.13 | Professional | None | $380.19 | $602.56 | $1,047.13 |
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 $234.42 Median $316.23 Typical High $338.84 | Professional | 52 · Reduced service | $234.42 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $125.89 Typical High $134.90 | Professional | 53 · Discontinued | $95.50 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $467.74 Typical High $501.19 | Professional | 54 · Surgery only | $354.81 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $93.33 Typical High $100.00 | Professional | 55 · Aftercare only | $70.79 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $63.10 Typical High $67.61 | Professional | 56 · Pre-op care only | $46.77 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $436.52 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $331.13 | $436.52 | $467.74 |
Where Ohio sits
The same service costs 5.8 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· 48th of 51
$513
AK $2,455TX $427
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.