How much rates vary
Facilitymedian $1,514 · 10th to 90th $562 to $5,888Professionalmedian $355 · 10th to 90th $55 to $589
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 $758.58 Median $2,691.53 Typical High $10,964.78 | Facility | None | $758.58 | $2,691.53 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $2,691.53 | Professional | None | $275.42 | $354.81 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,288.25 Typical High $4,466.84 | Facility | None | $524.81 | $1,288.25 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $512.86 | Professional | None | $245.47 | $338.84 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $1,348.96 Typical High $1,737.80 | Facility | None | $346.74 | $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 $295.12 Median $380.19 Typical High $741.31 | Professional | None | $295.12 | $380.19 | $741.31 |
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 $295.12 Median $380.19 Typical High $741.31 | Professional | None | $295.12 | $380.19 | $741.31 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $371.54 Typical High $537.03 | Professional | None | $38.02 | $371.54 | $537.03 |
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 $263.03 Median $380.19 Typical High $489.78 | Professional | None | $263.03 | $380.19 | $489.78 |
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 $295.12 Median $398.11 Typical High $758.58 | Professional | None | $295.12 | $398.11 | $758.58 |
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 $138.04 Median $177.83 Typical High $186.21 | Professional | 52 · Reduced service | $138.04 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $70.79 Typical High $74.13 | Professional | 53 · Discontinued | $54.95 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $269.15 Typical High $281.84 | Professional | 54 · Surgery only | $208.93 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $53.70 Typical High $56.23 | Professional | 55 · Aftercare only | $41.69 | $53.70 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $35.48 Typical High $37.15 | Professional | 56 · Pre-op care only | $27.54 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $251.19 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $194.98 | $251.19 | $263.03 |
Where Ohio sits
The same service costs 4.9 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· 47th of 51
$372
AK $1,479UT $302
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.