How much rates vary
Facilitymedian $1,413 · 10th to 90th $550 to $5,888Professionalmedian $407 · 10th to 90th $100 to $741
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 $724.44 Median $4,365.16 Typical High $12,589.25 | Facility | None | $724.44 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $549.54 | Professional | None | $239.88 | $354.81 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,202.26 Typical High $4,466.84 | Facility | None | $524.81 | $1,202.26 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $457.09 | Professional | None | $162.18 | $190.55 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $1,096.48 Typical High $1,412.54 | Facility | None | $436.52 | $1,096.48 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,230.27 Typical High $2,137.96 | Facility | None | $489.78 | $1,230.27 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $562.34 Typical High $831.76 | Professional | None | $338.84 | $562.34 | $831.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,258.93 Typical High $2,137.96 | Facility | None | $512.86 | $1,258.93 | $2,137.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $338.84 Median $562.34 Typical High $831.76 | Professional | None | $338.84 | $562.34 | $831.76 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $416.87 Typical High $758.58 | Professional | None | $67.61 | $416.87 | $758.58 |
SummaCare Setting Facility Modifier None Typical Low $602.56 Median $630.96 Typical High $724.44 | Facility | None | $602.56 | $630.96 | $724.44 |
SummaCare Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $724.44 | Professional | None | $354.81 | $501.19 | $724.44 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $5,888.44 | Facility | None | $691.83 | $1,445.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $831.76 | Professional | None | $239.88 | $407.38 | $831.76 |
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 $169.82 Median $275.42 Typical High $288.40 | Professional | 52 · Reduced service | $169.82 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $109.65 Typical High $114.82 | Professional | 53 · Discontinued | $69.18 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $416.87 Typical High $436.52 | Professional | 54 · Surgery only | $257.04 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $83.18 Typical High $87.10 | Professional | 55 · Aftercare only | $51.29 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $54.95 Typical High $57.54 | Professional | 56 · Pre-op care only | $34.67 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $389.05 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $239.88 | $389.05 | $407.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $281.84 Typical High $691.83 | Professional | 50 · Both sides | $239.88 | $281.84 | $691.83 |
Where Ohio sits
The same service costs 4.7 times more in Alaska than in Texas. 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· 48th of 51
$427
AK $1,660TX $355
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.