How much rates vary
Facilitymedian $513 · 10th to 90th $107 to $3,715Professionalmedian $191 · 10th to 90th $46 to $363
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 $316.23 Median $1,995.26 Typical High $10,964.78 | Facility | None | $316.23 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $257.04 Typical High $2,089.30 | Professional | None | $120.23 | $257.04 | $2,089.30 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $89.13 Median $107.15 Typical High $186.21 | Professional | None | $89.13 | $107.15 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $147.91 Median $194.98 Typical High $251.19 | Facility | None | $147.91 | $194.98 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $229.09 Typical High $416.87 | Facility | None | $58.88 | $229.09 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $245.47 Typical High $407.38 | Professional | None | $117.49 | $245.47 | $407.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $229.09 Typical High $380.19 | Facility | None | $58.88 | $229.09 | $380.19 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $117.49 Median $245.47 Typical High $407.38 | Professional | None | $117.49 | $245.47 | $407.38 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $229.09 Typical High $338.84 | Professional | None | $36.31 | $229.09 | $338.84 |
SummaCare Setting Facility Modifier None Typical Low $109.65 Median $114.82 Typical High $131.83 | Facility | None | $109.65 | $114.82 | $131.83 |
SummaCare Setting Professional Modifier None Typical Low $112.20 Median $263.03 Typical High $323.59 | Professional | None | $112.20 | $263.03 | $323.59 |
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 $102.33 Median $199.53 Typical High $446.68 | Professional | None | $102.33 | $199.53 | $446.68 |
6 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 $60.26 Median $128.82 Typical High $134.90 | Professional | 52 · Reduced service | $60.26 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $51.29 Typical High $53.70 | Professional | 53 · Discontinued | $23.99 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $194.98 Typical High $199.53 | Professional | 54 · Surgery only | $91.20 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $38.90 Typical High $39.81 | Professional | 55 · Aftercare only | $18.20 | $38.90 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $25.70 Typical High $26.92 | Professional | 56 · Pre-op care only | $12.02 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $181.97 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $85.11 | $181.97 | $186.21 |
Where Ohio sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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· 41st of 51
$209
AK $562KY $145
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.