How much rates vary
Facilitymedian $3,090 · 10th to 90th $851 to $10,715Professionalmedian $1,230 · 10th to 90th $141 to $1,950
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 $3,162.28 Median $9,772.37 Typical High $12,882.50 | Facility | None | $3,162.28 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $9,772.37 | Professional | None | $1,288.25 | $1,288.25 | $9,772.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,238.72 Typical High $7,762.47 | Facility | None | $794.33 | $2,238.72 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,995.26 | Professional | None | $933.25 | $1,148.15 | $1,995.26 |
CareSource Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $3,630.78 | Facility | None | $1,584.89 | $2,818.38 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,162.28 Typical High $4,897.79 | Facility | None | $794.33 | $3,162.28 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,570.40 | Professional | None | $1,148.15 | $1,348.96 | $2,570.40 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $851.14 Median $3,162.28 Typical High $4,570.88 | Facility | None | $851.14 | $3,162.28 | $4,570.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,348.96 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,122.02 Typical High $1,778.28 | Professional | None | $123.03 | $1,122.02 | $1,778.28 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,288.25 | $1,819.70 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,951.21 | Professional | None | $1,023.29 | $1,380.38 | $2,951.21 |
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 $645.65 Median $645.65 Typical High $1,819.70 | Professional | 52 · Reduced service | $645.65 | $645.65 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $741.31 | Professional | 53 · Discontinued | $257.04 | $257.04 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $2,754.23 | Professional | 54 · Surgery only | $977.24 | $977.24 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $549.54 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $371.54 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $2,570.40 |
Where Ohio sits
The same service costs 5.9 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· 45th of 51
$1,288
AK $5,495UT $933
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.