How much rates vary
Facilitymedian $1,514 · 10th to 90th $525 to $5,248Professionalmedian $457 · 10th to 90th $245 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 $707.95 Median $4,365.16 Typical High $12,589.25 | Facility | None | $707.95 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $3,311.31 | Professional | None | $363.08 | $512.86 | $3,311.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,202.26 Typical High $4,466.84 | Facility | None | $524.81 | $1,202.26 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $645.65 | Professional | None | $302.00 | $407.38 | $645.65 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $1,348.96 Typical High $1,737.80 | Facility | None | $446.68 | $1,348.96 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,548.82 Typical High $2,290.87 | Facility | None | $489.78 | $1,548.82 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $831.76 | Professional | None | $363.08 | $501.19 | $831.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,548.82 Typical High $2,238.72 | Facility | None | $512.86 | $1,548.82 | $2,238.72 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $831.76 | Professional | None | $363.08 | $501.19 | $831.76 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $501.19 Typical High $758.58 | Professional | None | $33.88 | $501.19 | $758.58 |
SummaCare Setting Facility Modifier None Typical Low $758.58 Median $794.33 Typical High $912.01 | Facility | None | $758.58 | $794.33 | $912.01 |
SummaCare Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $616.60 | Professional | None | $331.13 | $501.19 | $616.60 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,786.30 | Facility | None | $501.19 | $977.24 | $4,786.30 |
United Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $891.25 | Professional | None | $331.13 | $489.78 | $891.25 |
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 $181.97 Median $257.04 Typical High $263.03 | Professional | 52 · Reduced service | $181.97 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $102.33 Typical High $104.71 | Professional | 53 · Discontinued | $72.44 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $380.19 Typical High $389.05 | Professional | 54 · Surgery only | $275.42 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $75.86 Typical High $77.62 | Professional | 55 · Aftercare only | $54.95 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $51.29 Typical High $52.48 | Professional | 56 · Pre-op care only | $36.31 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $354.81 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $257.04 | $354.81 | $363.08 |
Where Ohio sits
The same service costs 4.4 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· 43rd of 51
$490
AK $1,950TX $447
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.