How much rates vary
Facilitymedian $955 · 10th to 90th $437 to $5,012Professionalmedian $186 · 10th to 90th $138 to $302
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 $1,122.02 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,122.02 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $4,168.69 | Professional | None | $181.97 | $181.97 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $295.12 | Professional | None | $134.90 | $186.21 | $295.12 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $204.17 Median $281.84 Typical High $436.52 | Professional | 50 · Both sides | $204.17 | $281.84 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $630.96 Typical High $831.76 | Facility | None | $223.87 | $630.96 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $707.95 Typical High $1,479.11 | Facility | None | $389.05 | $707.95 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $407.38 | Professional | None | $173.78 | $199.53 | $407.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $398.11 Median $707.95 Typical High $1,479.11 | Facility | None | $398.11 | $707.95 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $407.38 | Professional | None | $173.78 | $199.53 | $407.38 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $263.03 | Professional | None | $134.90 | $186.21 | $263.03 |
SummaCare Setting Facility Modifier None Typical Low $338.84 Median $354.81 Typical High $407.38 | Facility | None | $338.84 | $354.81 | $407.38 |
SummaCare Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $269.15 | Professional | None | $165.96 | $165.96 | $269.15 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $416.87 | Professional | None | $165.96 | $208.93 | $416.87 |
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 $91.20 Median $91.20 Typical High $281.84 | Professional | 52 · Reduced service | $91.20 | $91.20 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $112.20 | Professional | 53 · Discontinued | $36.31 | $36.31 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $416.87 | Professional | 54 · Surgery only | $138.04 | $138.04 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $83.18 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $56.23 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $389.05 |
Where Ohio sits
The same service costs 8.9 times more in Oklahoma 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
$200
OK $1,413UT $158
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.