How much rates vary
Facilitymedian $2,951 · 10th to 90th $724 to $10,715Professionalmedian $1,380 · 10th to 90th $170 to $2,089
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 $1,445.44 Median $1,445.44 Typical High $10,232.93 | Professional | None | $1,445.44 | $1,445.44 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $7,079.46 | Facility | None | $758.58 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,412.54 | $2,344.23 |
CareSource Setting Facility Modifier None Typical Low $1,819.70 Median $2,818.38 Typical High $3,630.78 | Facility | None | $1,819.70 | $2,818.38 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,884.03 Typical High $5,011.87 | Facility | None | $549.54 | $2,884.03 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,479.11 | $3,019.95 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $2,884.03 Typical High $4,897.79 | Facility | None | $549.54 | $2,884.03 | $4,897.79 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,479.11 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $1,174.90 Typical High $1,819.70 | Professional | None | $158.49 | $1,174.90 | $1,819.70 |
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 $1,348.96 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,348.96 | $1,348.96 | $2,041.74 |
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 $1,318.26 Median $1,621.81 Typical High $3,311.31 | Professional | None | $1,318.26 | $1,621.81 | $3,311.31 |
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 $724.44 Median $724.44 Typical High $2,691.53 | Professional | 52 · Reduced service | $724.44 | $724.44 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $1,071.52 | Professional | 53 · Discontinued | $295.12 | $295.12 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $4,073.80 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $812.83 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $812.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $537.03 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $3,801.89 |
Where Ohio sits
The same service costs 7.1 times more in Alaska than in Texas. 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· 46th of 51
$1,413
AK $6,026TX $851
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.