How much rates vary
Facilitymedian $2,291 · 10th to 90th $631 to $9,120Professionalmedian $389 · 10th to 90th $275 to $646
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 $1,737.80 Median $7,244.36 Typical High $12,589.25 | Facility | None | $1,737.80 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $9,549.93 | Professional | None | $436.52 | $436.52 | $9,549.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $630.96 | Professional | None | $331.13 | $389.05 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $1,905.46 Typical High $2,454.71 | Facility | None | $489.78 | $1,905.46 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,238.72 Typical High $6,025.60 | Facility | None | $549.54 | $2,238.72 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $912.01 | Professional | None | $389.05 | $478.63 | $912.01 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $2,238.72 Typical High $6,025.60 | Facility | None | $549.54 | $2,238.72 | $6,025.60 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $912.01 | Professional | None | $389.05 | $478.63 | $912.01 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $354.81 Typical High $478.63 | Professional | None | $223.87 | $354.81 | $478.63 |
SummaCare Setting Facility Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,288.25 | Facility | None | $1,071.52 | $1,122.02 | $1,288.25 |
SummaCare Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $691.83 | Professional | None | $371.54 | $407.38 | $691.83 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $1,202.26 | Professional | None | $416.87 | $575.44 | $1,202.26 |
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 $218.78 Median $218.78 Typical High $724.44 | Professional | 52 · Reduced service | $218.78 | $218.78 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $288.40 | Professional | 53 · Discontinued | $87.10 | $87.10 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $1,096.48 | Professional | 54 · Surgery only | $331.13 | $331.13 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $218.78 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $144.54 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $1,023.29 |
Where Ohio sits
The same service costs 5.5 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· 48th of 51
$437
AK $2,188KY $398
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.