How much rates vary
Facilitymedian $1,862 · 10th to 90th $724 to $8,913Professionalmedian $282 · 10th to 90th $49 to $525
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 $269.15 Median $398.11 Typical High $1,621.81 | Professional | None | $269.15 | $398.11 | $1,621.81 |
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 $169.82 Median $199.53 Typical High $371.54 | Professional | None | $169.82 | $199.53 | $371.54 |
Aultcare Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $1,513.56 Typical High $1,995.26 | Facility | None | $346.74 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $3,019.95 | Facility | None | $691.83 | $1,737.80 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $645.65 | Professional | None | $281.84 | $416.87 | $645.65 |
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 $281.84 Median $416.87 Typical High $645.65 | Professional | None | $281.84 | $416.87 | $645.65 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $251.19 Typical High $457.09 | Professional | None | $33.88 | $251.19 | $457.09 |
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 $269.15 Median $346.74 Typical High $478.63 | Professional | None | $269.15 | $346.74 | $478.63 |
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 $218.78 Median $363.08 Typical High $660.69 | Professional | None | $218.78 | $363.08 | $660.69 |
8 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 $134.90 Median $199.53 Typical High $213.80 | Professional | 52 · Reduced service | $134.90 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $79.43 Typical High $85.11 | Professional | 53 · Discontinued | $53.70 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $295.12 Typical High $323.59 | Professional | 54 · Surgery only | $204.17 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $58.88 Typical High $64.57 | Professional | 55 · Aftercare only | $40.74 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $39.81 Typical High $42.66 | Professional | 56 · Pre-op care only | $26.92 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $275.42 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $190.55 | $275.42 | $302.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $251.19 Median $295.12 Typical High $549.54 | Professional | 50 · Both sides | $251.19 | $295.12 | $549.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $104.71 Median $123.03 Typical High $234.42 | Professional | 62 · Two surgeons | $104.71 | $123.03 | $234.42 |
Where Ohio sits
The same service costs 5.9 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· 49th of 51
$302
AK $1,413UT $240
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.