How much rates vary
Facilitymedian $501 · 10th to 90th $81 to $4,074Professionalmedian $162 · 10th to 90th $95 to $269
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 $501.19 Median $3,235.94 Typical High $12,589.25 | Facility | None | $501.19 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $2,511.89 | Professional | None | $107.15 | $177.83 | $2,511.89 |
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 $69.18 Median $95.50 Typical High $162.18 | Professional | None | $69.18 | $95.50 | $162.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $102.33 Median $141.25 Typical High $239.88 | Professional | 50 · Both sides | $102.33 | $141.25 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $134.90 Typical High $154.88 | Facility | None | $120.23 | $134.90 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $138.04 Typical High $251.19 | Facility | None | $58.88 | $138.04 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $331.13 | Professional | None | $104.71 | $177.83 | $331.13 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $138.04 Typical High $234.42 | Facility | None | $58.88 | $138.04 | $234.42 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $331.13 | Professional | None | $104.71 | $177.83 | $331.13 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $257.04 | Professional | None | $128.82 | $186.21 | $257.04 |
SummaCare Setting Facility Modifier None Typical Low $66.07 Median $69.18 Typical High $79.43 | Facility | None | $66.07 | $69.18 | $79.43 |
SummaCare Setting Professional Modifier None Typical Low $102.33 Median $186.21 Typical High $239.88 | Professional | None | $102.33 | $186.21 | $239.88 |
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 $91.20 Median $158.49 Typical High $323.59 | Professional | None | $91.20 | $158.49 | $323.59 |
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 $53.70 Median $89.13 Typical High $91.20 | Professional | 52 · Reduced service | $53.70 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $35.48 Typical High $36.31 | Professional | 53 · Discontinued | $21.38 | $35.48 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $134.90 Typical High $138.04 | Professional | 54 · Surgery only | $81.28 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $26.92 Typical High $27.54 | Professional | 55 · Aftercare only | $16.22 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $17.78 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.72 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $125.89 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $75.86 | $125.89 | $128.82 |
Where Ohio sits
The same service costs 4.5 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· 43rd of 51
$166
AK $457KY $102
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.