How much rates vary
Facilitymedian $871 · 10th to 90th $288 to $4,898Professionalmedian $209 · 10th to 90th $95 to $380
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 $794.33 Median $3,235.94 Typical High $12,589.25 | Facility | None | $794.33 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $323.59 | Professional | None | $186.21 | $288.40 | $323.59 |
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 $107.15 Median $147.91 Typical High $275.42 | Professional | None | $107.15 | $147.91 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $234.42 Typical High $309.03 | Facility | None | $229.09 | $234.42 | $309.03 |
CareSource Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $218.78 | Professional | None | $194.98 | $194.98 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $371.54 Typical High $1,479.11 | Facility | None | $257.04 | $371.54 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $416.87 | Professional | None | $186.21 | $288.40 | $416.87 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $263.03 Median $371.54 Typical High $1,479.11 | Facility | None | $263.03 | $371.54 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $407.38 | Professional | None | $186.21 | $288.40 | $407.38 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $245.47 Typical High $398.11 | Professional | None | $30.90 | $245.47 | $398.11 |
SummaCare Setting Facility Modifier None Typical Low $138.04 Median $144.54 Typical High $165.96 | Facility | None | $138.04 | $144.54 | $165.96 |
SummaCare Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $363.08 | Professional | None | $190.55 | $281.84 | $363.08 |
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 $151.36 Median $223.87 Typical High $371.54 | Professional | None | $151.36 | $223.87 | $371.54 |
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 $93.33 Median $144.54 Typical High $147.91 | Professional | 52 · Reduced service | $93.33 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $57.54 Typical High $60.26 | Professional | 53 · Discontinued | $37.15 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $218.78 Typical High $223.87 | Professional | 54 · Surgery only | $138.04 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $43.65 Typical High $44.67 | Professional | 55 · Aftercare only | $28.18 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $28.84 Typical High $30.20 | Professional | 56 · Pre-op care only | $18.62 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $204.17 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $128.82 | $204.17 | $208.93 |
Where Ohio sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$214
AK $794KY $178
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.