How much rates vary
Facilitymedian $6,026 · 10th to 90th $912 to $15,136Professionalmedian $339 · 10th to 90th $257 to $692
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 $1,819.70 Median $7,585.78 Typical High $12,589.25 | Facility | None | $1,819.70 | $7,585.78 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $933.25 Typical High $9,332.54 | Professional | None | $371.54 | $933.25 | $9,332.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,890.45 Typical High $20,892.96 | Facility | None | $1,047.13 | $3,890.45 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $537.03 | Professional | None | $288.40 | $338.84 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $407.38 Median $6,165.95 Typical High $8,128.31 | Facility | None | $407.38 | $6,165.95 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $6,918.31 Typical High $12,882.50 | Facility | None | $549.54 | $6,918.31 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $794.33 | Professional | None | $323.59 | $407.38 | $794.33 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $6,918.31 Typical High $12,882.50 | Facility | None | $549.54 | $6,918.31 | $12,882.50 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $794.33 | Professional | None | $323.59 | $407.38 | $794.33 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $407.38 | Professional | None | $234.42 | $302.00 | $407.38 |
SummaCare Setting Facility Modifier None Typical Low $3,311.31 Median $3,467.37 Typical High $3,981.07 | Facility | None | $3,311.31 | $3,467.37 | $3,981.07 |
SummaCare Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $588.84 | Professional | None | $309.03 | $338.84 | $588.84 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,570.88 Typical High $19,952.62 | Facility | None | $1,071.52 | $4,570.88 | $19,952.62 |
United Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $1,000.00 | Professional | None | $354.81 | $489.78 | $1,000.00 |
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 $186.21 Median $186.21 Typical High $467.74 | Professional | 52 · Reduced service | $186.21 | $186.21 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $190.55 | Professional | 53 · Discontinued | $74.13 | $74.13 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $707.95 | Professional | 54 · Surgery only | $275.42 | $275.42 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $141.25 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $93.33 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $660.69 |
Where Ohio sits
The same service costs 21.5 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $21,837MT $1,015
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.