How much rates vary
Facilitymedian $1,380 · 10th to 90th $525 to $5,248Professionalmedian $302 · 10th to 90th $170 to $479
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 $2,691.53 Typical High $10,964.78 | Facility | None | $707.95 | $2,691.53 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $758.58 | Professional | None | $257.04 | $346.74 | $758.58 |
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 $223.87 Median $275.42 Typical High $416.87 | Professional | None | $223.87 | $275.42 | $416.87 |
CareSource Setting Facility Modifier None Typical Low $323.59 Median $1,348.96 Typical High $1,737.80 | Facility | None | $323.59 | $1,348.96 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $309.03 | Professional | None | $275.42 | $275.42 | $309.03 |
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 $269.15 Median $354.81 Typical High $537.03 | Professional | None | $269.15 | $354.81 | $537.03 |
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 $269.15 Median $354.81 Typical High $537.03 | Professional | None | $269.15 | $354.81 | $537.03 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $281.84 Typical High $467.74 | Professional | None | $30.20 | $281.84 | $467.74 |
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 $245.47 Median $346.74 Typical High $426.58 | Professional | None | $245.47 | $346.74 | $426.58 |
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 $239.88 Median $331.13 Typical High $501.19 | Professional | None | $239.88 | $331.13 | $501.19 |
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 $128.82 Median $173.78 Typical High $181.97 | Professional | 52 · Reduced service | $128.82 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $69.18 Typical High $72.44 | Professional | 53 · Discontinued | $51.29 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $263.03 Typical High $269.15 | Professional | 54 · Surgery only | $194.98 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $52.48 Typical High $53.70 | Professional | 55 · Aftercare only | $38.90 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $34.67 Typical High $36.31 | Professional | 56 · Pre-op care only | $25.70 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $245.47 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $181.97 | $245.47 | $251.19 |
Where Ohio sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 46th of 51
$309
AK $1,072NJ $263
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.