How much rates vary
Facilitymedian $501 · 10th to 90th $81 to $4,074Professionalmedian $151 · 10th to 90th $40 to $251
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 $489.78 Median $3,235.94 Typical High $12,589.25 | Facility | None | $489.78 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $190.55 | Professional | None | $117.49 | $144.54 | $190.55 |
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 $75.86 Median $89.13 Typical High $199.53 | Professional | None | $75.86 | $89.13 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $154.88 Typical High $186.21 | Facility | None | $117.49 | $154.88 | $186.21 |
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 $147.91 Median $190.55 Typical High $295.12 | Professional | None | $147.91 | $190.55 | $295.12 |
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 $147.91 Median $190.55 Typical High $288.40 | Professional | None | $147.91 | $190.55 | $288.40 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $138.04 Typical High $245.47 | Professional | None | $30.20 | $138.04 | $245.47 |
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 $154.88 Median $190.55 Typical High $223.87 | Professional | None | $154.88 | $190.55 | $223.87 |
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 $107.15 Median $162.18 Typical High $288.40 | Professional | None | $107.15 | $162.18 | $288.40 |
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 $72.44 Median $87.10 Typical High $93.33 | Professional | 52 · Reduced service | $72.44 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $34.67 Typical High $37.15 | Professional | 53 · Discontinued | $28.84 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $131.83 Typical High $141.25 | Professional | 54 · Surgery only | $109.65 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $26.30 Typical High $28.18 | Professional | 55 · Aftercare only | $21.88 | $26.30 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $17.38 Typical High $18.62 | Professional | 56 · Pre-op care only | $14.45 | $17.38 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $123.03 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $102.33 | $123.03 | $131.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $114.82 Median $134.90 Typical High $302.00 | Professional | 50 · Both sides | $114.82 | $134.90 | $302.00 |
Where Ohio sits
The same service costs 4.6 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
$155
AK $617FL $135
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.