How much rates vary
Facilitymedian $794 · 10th to 90th $355 to $4,677Professionalmedian $155 · 10th to 90th $52 to $269
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 $194.98 Median $691.83 Typical High $10,715.19 | Facility | None | $194.98 | $691.83 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $363.08 | Professional | None | $107.15 | $204.17 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $457.09 Median $1,148.15 Typical High $4,466.84 | Facility | None | $457.09 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $223.87 | Professional | None | $79.43 | $125.89 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $630.96 Typical High $831.76 | Facility | None | $131.83 | $630.96 | $831.76 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $125.89 | Professional | None | $112.20 | $112.20 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $707.95 Typical High $1,479.11 | Facility | None | $363.08 | $707.95 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $302.00 | Professional | None | $107.15 | $204.17 | $302.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $707.95 Typical High $1,479.11 | Facility | None | $389.05 | $707.95 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $302.00 | Professional | None | $107.15 | $204.17 | $302.00 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $154.88 Typical High $269.15 | Professional | None | $30.20 | $154.88 | $269.15 |
SummaCare Setting Facility Modifier None Typical Low $338.84 Median $354.81 Typical High $407.38 | Facility | None | $338.84 | $354.81 | $407.38 |
SummaCare Setting Professional Modifier None Typical Low $102.33 Median $204.17 Typical High $239.88 | Professional | None | $102.33 | $204.17 | $239.88 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $95.50 Median $165.96 Typical High $263.03 | Professional | None | $95.50 | $165.96 | $263.03 |
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 $53.70 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $53.70 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $21.38 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $79.43 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $16.22 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $10.72 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $144.54 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $74.13 | $144.54 | $144.54 |
Where Ohio sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 44th of 51
$158
AK $447DC $135
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.