How much rates vary
Facilitymedian $501 · 10th to 90th $81 to $4,074Professionalmedian $195 · 10th to 90th $43 to $324
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 $758.58 Median $3,235.94 Typical High $12,589.25 | Facility | None | $758.58 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $851.14 | Professional | None | $194.98 | $229.09 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $83.18 Median $97.72 Typical High $263.03 | Professional | None | $83.18 | $97.72 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $251.19 | Facility | None | $125.89 | $162.18 | $251.19 |
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 $190.55 Median $239.88 Typical High $363.08 | Professional | None | $190.55 | $239.88 | $363.08 |
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 $190.55 Median $239.88 Typical High $363.08 | Professional | None | $190.55 | $239.88 | $363.08 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $190.55 Typical High $323.59 | Professional | None | $32.36 | $190.55 | $323.59 |
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 $204.17 Median $251.19 Typical High $309.03 | Professional | None | $204.17 | $251.19 | $309.03 |
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 $123.03 Median $190.55 Typical High $354.81 | Professional | None | $123.03 | $190.55 | $354.81 |
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 $97.72 Median $114.82 Typical High $120.23 | Professional | 52 · Reduced service | $97.72 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $45.71 Typical High $47.86 | Professional | 53 · Discontinued | $38.90 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $173.78 Typical High $177.83 | Professional | 54 · Surgery only | $144.54 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $34.67 Typical High $35.48 | Professional | 55 · Aftercare only | $28.84 | $34.67 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $22.91 Typical High $23.99 | Professional | 56 · Pre-op care only | $19.50 | $22.91 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $162.18 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $134.90 | $162.18 | $165.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $125.89 Median $147.91 Typical High $389.05 | Professional | 50 · Both sides | $125.89 | $147.91 | $389.05 |
Where Ohio sits
The same service costs 5.0 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· 45th of 51
$200
AK $832FL $166
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.