How much rates vary
Facilitymedian $513 · 10th to 90th $100 to $3,715Professionalmedian $186 · 10th to 90th $47 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 $346.74 Median $691.83 Typical High $10,715.19 | Facility | None | $346.74 | $691.83 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $512.86 | Professional | None | $147.91 | $204.17 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $251.19 | Professional | None | $93.33 | $109.65 | $251.19 |
Aultcare Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $263.03 | Professional | None | $257.04 | $257.04 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $239.88 | Facility | None | $125.89 | $162.18 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $144.54 Typical High $245.47 | Facility | None | $58.88 | $144.54 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $354.81 | Professional | None | $186.21 | $234.42 | $354.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $144.54 Typical High $245.47 | Facility | None | $58.88 | $144.54 | $245.47 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $354.81 | Professional | None | $186.21 | $234.42 | $354.81 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $173.78 Typical High $288.40 | Professional | None | $32.36 | $173.78 | $288.40 |
SummaCare Setting Facility Modifier None Typical Low $69.18 Median $72.44 Typical High $83.18 | Facility | None | $69.18 | $72.44 | $83.18 |
SummaCare Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $302.00 | Professional | None | $194.98 | $229.09 | $302.00 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $354.81 | Professional | None | $131.83 | $204.17 | $354.81 |
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 $93.33 Median $102.33 Typical High $112.20 | Professional | 52 · Reduced service | $93.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $41.69 Typical High $44.67 | Professional | 53 · Discontinued | $37.15 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $154.88 Typical High $165.96 | Professional | 54 · Surgery only | $141.25 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $30.90 Typical High $33.11 | Professional | 55 · Aftercare only | $28.18 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $20.42 Typical High $22.39 | Professional | 56 · Pre-op care only | $18.62 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $144.54 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $131.83 | $144.54 | $154.88 |
Where Ohio sits
The same service costs 4.8 times more in Alaska than in Florida. 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· 47th of 51
$191
AK $794FL $166
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.