How much rates vary
Facilitymedian $1,413 · 10th to 90th $562 to $6,166Professionalmedian $479 · 10th to 90th $87 to $776
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 $1,698.24 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,698.24 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $4,786.30 | Professional | None | $489.78 | $489.78 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,148.15 Typical High $4,466.84 | Facility | None | $524.81 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $707.95 | Professional | None | $302.00 | $416.87 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $616.60 Median $1,174.90 Typical High $1,513.56 | Facility | None | $616.60 | $1,174.90 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,318.26 Typical High $2,187.76 | Facility | None | $489.78 | $1,318.26 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $1,000.00 | Professional | None | $467.74 | $524.81 | $1,000.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,318.26 Typical High $2,187.76 | Facility | None | $512.86 | $1,318.26 | $2,187.76 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $1,000.00 | Professional | None | $467.74 | $524.81 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $446.68 Typical High $707.95 | Professional | None | $77.62 | $446.68 | $707.95 |
SummaCare Setting Facility Modifier None Typical Low $645.65 Median $676.08 Typical High $758.58 | Facility | None | $645.65 | $676.08 | $758.58 |
SummaCare Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $707.95 | Professional | None | $501.19 | $501.19 | $707.95 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $1,122.02 | Professional | None | $389.05 | $537.03 | $1,122.02 |
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 $245.47 Median $245.47 Typical High $812.83 | Professional | 52 · Reduced service | $245.47 | $245.47 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $323.59 | Professional | 53 · Discontinued | $97.72 | $97.72 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $1,202.26 | Professional | 54 · Surgery only | $363.08 | $363.08 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $245.47 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $162.18 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $1,122.02 |
Where Ohio sits
The same service costs 5.5 times more in Alaska 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
$490
AK $2,042UT $372
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.