How much rates vary
Facilitymedian $2,512 · 10th to 90th $741 to $9,120Professionalmedian $501 · 10th to 90th $380 to $832
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 $1,905.46 Median $8,511.38 Typical High $13,803.84 | Facility | None | $1,905.46 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $10,232.93 | Professional | None | $537.03 | $537.03 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,737.80 Typical High $7,762.47 | Facility | None | $707.95 | $1,737.80 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $758.58 | Professional | None | $380.19 | $467.74 | $758.58 |
CareSource Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $2,884.03 | Facility | None | $588.84 | $2,187.76 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,454.71 Typical High $3,715.35 | Facility | None | $741.31 | $2,454.71 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $1,071.52 | Professional | None | $478.63 | $588.84 | $1,071.52 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $2,454.71 Typical High $3,548.13 | Facility | None | $741.31 | $2,454.71 | $3,548.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $1,071.52 | Professional | None | $478.63 | $602.56 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $478.63 Typical High $630.96 | Professional | None | $44.67 | $478.63 | $630.96 |
SummaCare Setting Facility Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $1,412.54 | Facility | None | $1,202.26 | $1,258.93 | $1,412.54 |
SummaCare Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $912.01 | Professional | None | $489.78 | $537.03 | $912.01 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $1,445.44 | Professional | None | $501.19 | $630.96 | $1,445.44 |
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 $263.03 Median $263.03 Typical High $794.33 | Professional | 52 · Reduced service | $263.03 | $263.03 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $316.23 | Professional | 53 · Discontinued | $107.15 | $107.15 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $1,202.26 | Professional | 54 · Surgery only | $398.11 | $398.11 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $239.88 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $158.49 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $1,122.02 |
Where Ohio sits
The same service costs 5.4 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· 49th of 51
$550
AK $2,630TX $490
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.