How much rates vary
Facilitymedian $525 · 10th to 90th $100 to $3,715Professionalmedian $200 · 10th to 90th $49 to $324
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 $363.08 Median $707.95 Typical High $10,715.19 | Facility | None | $363.08 | $707.95 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $512.86 | Professional | None | $162.18 | $213.80 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $281.84 | Professional | None | $131.83 | $204.17 | $281.84 |
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 $269.15 | Professional | None | $93.33 | $109.65 | $269.15 |
Aultcare Setting Professional Modifier None Typical Low $263.03 Median $269.15 Typical High $398.11 | Professional | None | $263.03 | $269.15 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $257.04 | Facility | None | $125.89 | $162.18 | $257.04 |
CareSource Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $323.59 | Professional | None | $208.93 | $263.03 | $323.59 |
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 $199.53 Median $251.19 Typical High $371.54 | Professional | None | $199.53 | $251.19 | $371.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $147.91 Typical High $316.23 | Facility | None | $58.88 | $147.91 | $316.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $346.74 | Professional | None | $181.97 | $251.19 | $346.74 |
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 $208.93 Median $234.42 Typical High $354.81 | Professional | None | $208.93 | $234.42 | $354.81 |
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 $134.90 Median $208.93 Typical High $371.54 | Professional | None | $134.90 | $208.93 | $371.54 |
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 $100.00 Median $107.15 Typical High $114.82 | Professional | 52 · Reduced service | $100.00 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $42.66 Typical High $45.71 | Professional | 53 · Discontinued | $39.81 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $158.49 Typical High $173.78 | Professional | 54 · Surgery only | $151.36 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $31.62 Typical High $34.67 | Professional | 55 · Aftercare only | $30.20 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.38 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.95 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $147.91 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $141.25 | $147.91 | $162.18 |
Where Ohio sits
The same service costs 5.1 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· 46th of 51
$200
AK $871UT $170
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.