How much rates vary
Facilitymedian $2,512 · 10th to 90th $692 to $7,762Professionalmedian $794 · 10th to 90th $112 to $1,318
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 $1,230.27 Median $2,630.27 Typical High $10,964.78 | Facility | None | $1,230.27 | $2,630.27 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $4,168.69 | Professional | None | $660.69 | $912.01 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $2,238.72 Typical High $7,079.46 | Facility | None | $691.83 | $2,238.72 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $724.44 Typical High $1,148.15 | Professional | None | $524.81 | $724.44 | $1,148.15 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $2,818.38 Typical High $3,630.78 | Facility | None | $758.58 | $2,818.38 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,884.03 Typical High $4,897.79 | Facility | None | $602.56 | $2,884.03 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,513.56 | Professional | None | $645.65 | $912.01 | $1,513.56 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $2,884.03 Typical High $4,570.88 | Facility | None | $602.56 | $2,884.03 | $4,570.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,621.81 | Professional | None | $645.65 | $912.01 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $851.14 Typical High $1,202.26 | Professional | None | $79.43 | $851.14 | $1,202.26 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $1,096.48 | Professional | None | $549.54 | $831.76 | $1,096.48 |
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 $630.96 Median $912.01 Typical High $1,819.70 | Professional | None | $630.96 | $912.01 | $1,819.70 |
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 $331.13 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $331.13 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $131.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $501.19 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $100.00 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $66.07 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $467.74 | $630.96 | $630.96 |
Where Ohio sits
The same service costs 5.2 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
$832
AK $3,548UT $676
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.