How much rates vary
Facilitymedian $1,514 · 10th to 90th $457 to $5,248Professionalmedian $427 · 10th to 90th $44 to $603
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 $1,380.38 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,380.38 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $1,584.89 | Professional | None | $436.52 | $436.52 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $1,202.26 Typical High $4,466.84 | Facility | None | $467.74 | $1,202.26 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $645.65 | Professional | None | $371.54 | $436.52 | $645.65 |
CareSource Setting Facility Modifier None Typical Low $537.03 Median $1,348.96 Typical High $1,737.80 | Facility | None | $537.03 | $1,348.96 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $524.81 | Professional | None | $457.09 | $457.09 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,479.11 Typical High $2,290.87 | Facility | None | $363.08 | $1,479.11 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $776.25 | Professional | None | $416.87 | $446.68 | $776.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $1,479.11 Typical High $2,238.72 | Facility | None | $389.05 | $1,479.11 | $2,238.72 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $426.58 Median $446.68 Typical High $776.25 | Professional | None | $426.58 | $446.68 | $776.25 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $338.84 Typical High $549.54 | Professional | None | $30.90 | $338.84 | $549.54 |
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 $426.58 Median $426.58 Typical High $501.19 | Professional | None | $426.58 | $426.58 | $501.19 |
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 $354.81 Median $457.09 Typical High $691.83 | Professional | None | $354.81 | $457.09 | $691.83 |
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 $218.78 Median $218.78 Typical High $281.84 | Professional | 52 · Reduced service | $218.78 | $218.78 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $112.20 | Professional | 53 · Discontinued | $87.10 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $416.87 | Professional | 54 · Surgery only | $323.59 | $323.59 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $83.18 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $56.23 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $389.05 |
Where Ohio sits
The same service costs 6.2 times more in Alaska than in Texas. 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· 42nd of 51
$437
AK $1,862TX $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.