How much rates vary
Facilitymedian $2,951 · 10th to 90th $759 to $10,233Professionalmedian $562 · 10th to 90th $98 to $955
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 $912.01 Median $8,128.31 Typical High $13,803.84 | Facility | None | $912.01 | $8,128.31 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $4,677.35 | Professional | None | $457.09 | $588.84 | $4,677.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,238.72 Typical High $7,762.47 | Facility | None | $758.58 | $2,238.72 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $758.58 | Professional | None | $407.38 | $478.63 | $758.58 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $2,818.38 Typical High $3,630.78 | Facility | None | $562.34 | $2,818.38 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,951.21 Typical High $4,897.79 | Facility | None | $741.31 | $2,951.21 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $1,230.27 | Professional | None | $478.63 | $630.96 | $1,230.27 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $3,019.95 Typical High $4,570.88 | Facility | None | $741.31 | $3,019.95 | $4,570.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $1,258.93 | Professional | None | $478.63 | $630.96 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $549.54 Typical High $870.96 | Professional | None | $81.28 | $549.54 | $870.96 |
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 $426.58 Median $616.60 Typical High $812.83 | Professional | None | $426.58 | $616.60 | $812.83 |
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 $446.68 Median $616.60 Typical High $1,174.90 | Professional | None | $446.68 | $616.60 | $1,174.90 |
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 $223.87 Median $295.12 Typical High $316.23 | Professional | 52 · Reduced service | $223.87 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $117.49 Typical High $125.89 | Professional | 53 · Discontinued | $91.20 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $446.68 Typical High $467.74 | Professional | 54 · Surgery only | $338.84 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $89.13 Typical High $95.50 | Professional | 55 · Aftercare only | $67.61 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $58.88 Typical High $63.10 | Professional | 56 · Pre-op care only | $45.71 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $416.87 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $316.23 | $416.87 | $436.52 |
Where Ohio sits
The same service costs 5.0 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· 48th of 51
$589
AK $2,344UT $468
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.