How much rates vary
Facilitymedian $398 · 10th to 90th $83 to $3,715Professionalmedian $117 · 10th to 90th $42 to $186
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 $208.93 Median $398.11 Typical High $10,715.19 | Facility | None | $208.93 | $398.11 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $323.59 | Professional | None | $91.20 | $117.49 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
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 $54.95 Median $64.57 Typical High $147.91 | Professional | None | $54.95 | $64.57 | $147.91 |
Aultcare Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $100.00 Typical High $151.36 | Facility | None | $77.62 | $100.00 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $95.50 Typical High $169.82 | Facility | None | $58.88 | $95.50 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $204.17 | Professional | None | $117.49 | $144.54 | $204.17 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $97.72 Typical High $269.15 | Facility | None | $58.88 | $97.72 | $269.15 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $204.17 | Professional | None | $109.65 | $144.54 | $204.17 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $100.00 Typical High $165.96 | Professional | None | $30.20 | $100.00 | $165.96 |
SummaCare Setting Facility Modifier None Typical Low $45.71 Median $47.86 Typical High $53.70 | Facility | None | $45.71 | $47.86 | $53.70 |
SummaCare Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $162.18 | Professional | None | $123.03 | $128.82 | $162.18 |
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 $75.86 Median $123.03 Typical High $208.93 | Professional | None | $75.86 | $123.03 | $208.93 |
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 $58.88 Median $58.88 Typical High $64.57 | Professional | 52 · Reduced service | $58.88 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $25.70 | Professional | 53 · Discontinued | $23.44 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $89.13 Typical High $95.50 | Professional | 54 · Surgery only | $89.13 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $19.05 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $12.88 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $83.18 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $83.18 | $83.18 | $89.13 |
Ambetter Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $169.82 Typical High $199.53 | Professional | 54 · Surgery only | $144.54 | $169.82 | $199.53 |
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· 47th of 51
$117
AK $501UT $97.72
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.