How much rates vary
Facilitymedian $468 · 10th to 90th $98 to $3,715Professionalmedian $141 · 10th to 90th $46 to $240
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 $251.19 Median $1,949.84 Typical High $10,964.78 | Facility | None | $251.19 | $1,949.84 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $389.05 | Professional | None | $109.65 | $144.54 | $389.05 |
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 $70.79 Median $83.18 Typical High $186.21 | Professional | None | $70.79 | $83.18 | $186.21 |
Aultcare Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $107.15 Median $138.04 Typical High $177.83 | Facility | None | $107.15 | $138.04 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $125.89 Typical High $213.80 | Facility | None | $58.88 | $125.89 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $269.15 | Professional | None | $141.25 | $177.83 | $269.15 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $125.89 Typical High $213.80 | Facility | None | $58.88 | $125.89 | $213.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $263.03 | Professional | None | $141.25 | $177.83 | $263.03 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $123.03 Typical High $234.42 | Professional | None | $32.36 | $123.03 | $234.42 |
SummaCare Setting Facility Modifier None Typical Low $60.26 Median $64.57 Typical High $72.44 | Facility | None | $60.26 | $64.57 | $72.44 |
SummaCare Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $204.17 | Professional | None | $144.54 | $173.78 | $204.17 |
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 $100.00 Median $151.36 Typical High $269.15 | Professional | None | $100.00 | $151.36 | $269.15 |
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 $70.79 Median $79.43 Typical High $85.11 | Professional | 52 · Reduced service | $70.79 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $32.36 Typical High $33.88 | Professional | 53 · Discontinued | $28.18 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $120.23 Typical High $128.82 | Professional | 54 · Surgery only | $104.71 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $23.99 Typical High $25.70 | Professional | 55 · Aftercare only | $20.89 | $23.99 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.85 Typical High $16.98 | Professional | 56 · Pre-op care only | $14.13 | $15.85 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $112.20 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $97.72 | $112.20 | $120.23 |
Ambetter Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 54 · Surgery only | $91.20 | $91.20 | $91.20 |
Where Ohio sits
The same service costs 4.9 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· 47th of 51
$141
AK $603UT $123
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.