How much rates vary
Facilitymedian $871 · 10th to 90th $148 to $5,248Professionalmedian $148 · 10th to 90th $102 to $240
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 $302.00 Median $4,365.16 Typical High $12,589.25 | Facility | None | $302.00 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $331.13 | Professional | None | $107.15 | $181.97 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,174.90 Typical High $4,570.88 | Facility | None | $524.81 | $1,174.90 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $194.98 | Professional | None | $91.20 | $125.89 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $123.03 Median $134.90 Typical High $162.18 | Facility | None | $123.03 | $134.90 | $162.18 |
CareSource Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $128.82 | Professional | None | $114.82 | $114.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $245.47 Typical High $1,995.26 | Facility | None | $131.83 | $245.47 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $275.42 | Professional | None | $109.65 | $173.78 | $275.42 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $131.83 Median $234.42 Typical High $1,995.26 | Facility | None | $131.83 | $234.42 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $269.15 | Professional | None | $109.65 | $173.78 | $269.15 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $239.88 | Professional | None | $112.20 | $154.88 | $239.88 |
SummaCare Setting Facility Modifier None Typical Low $70.79 Median $74.13 Typical High $83.18 | Facility | None | $70.79 | $74.13 | $83.18 |
SummaCare Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $218.78 | Professional | None | $102.33 | $151.36 | $218.78 |
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 $97.72 Median $144.54 Typical High $229.09 | Professional | None | $97.72 | $144.54 | $229.09 |
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 $89.13 Typical High $91.20 | Professional | 52 · Reduced service | $53.70 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $35.48 Typical High $36.31 | Professional | 53 · Discontinued | $21.88 | $35.48 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $134.90 Typical High $134.90 | Professional | 54 · Surgery only | $81.28 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $16.22 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $17.78 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.72 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $125.89 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $75.86 | $125.89 | $125.89 |
Where Ohio sits
The same service costs 3.4 times more in Alaska than in Florida. 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· 40th of 51
$148
AK $447FL $132
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.