How much rates vary
Facilitymedian $389 · 10th to 90th $79 to $3,715Professionalmedian $107 · 10th to 90th $40 to $174
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 $275.42 Median $1,995.26 Typical High $10,964.78 | Facility | None | $275.42 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $309.03 | Professional | None | $81.28 | $100.00 | $309.03 |
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 $61.66 Median $61.66 Typical High $138.04 | Professional | None | $61.66 | $61.66 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $100.00 Typical High $128.82 | Facility | None | $77.62 | $100.00 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $91.20 Typical High $169.82 | Facility | None | $58.88 | $91.20 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $190.55 | Professional | None | $100.00 | $125.89 | $190.55 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $91.20 Typical High $169.82 | Facility | None | $58.88 | $91.20 | $169.82 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $190.55 | Professional | None | $100.00 | $125.89 | $190.55 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $102.33 Typical High $165.96 | Professional | None | $30.20 | $102.33 | $165.96 |
SummaCare Setting Facility Modifier None Typical Low $43.65 Median $45.71 Typical High $51.29 | Facility | None | $43.65 | $45.71 | $51.29 |
SummaCare Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $144.54 | Professional | None | $102.33 | $123.03 | $144.54 |
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 $70.79 Median $112.20 Typical High $190.55 | Professional | None | $70.79 | $112.20 | $190.55 |
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 $50.12 Median $56.23 Typical High $58.88 | Professional | 52 · Reduced service | $50.12 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $22.91 Typical High $23.44 | Professional | 53 · Discontinued | $19.95 | $22.91 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $85.11 Typical High $89.13 | Professional | 54 · Surgery only | $74.13 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.98 Typical High $17.78 | Professional | 55 · Aftercare only | $14.79 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $11.48 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.00 | $11.48 | $11.75 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $79.43 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $69.18 | $79.43 | $83.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $79.43 Median $93.33 Typical High $199.53 | Professional | 50 · Both sides | $79.43 | $93.33 | $199.53 |
Where Ohio sits
The same service costs 4.5 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· 43rd of 51
$110
AK $427FL $95.50
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.