How much rates vary
Facilitymedian $933 · 10th to 90th $282 to $5,248Professionalmedian $269 · 10th to 90th $48 to $468
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 $501.19 Median $3,235.94 Typical High $12,589.25 | Facility | None | $501.19 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $371.54 | Professional | None | $218.78 | $338.84 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,202.26 Typical High $4,570.88 | Facility | None | $524.81 | $1,202.26 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $380.19 | Professional | None | $177.83 | $234.42 | $380.19 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $275.42 Typical High $281.84 | Facility | None | $218.78 | $275.42 | $281.84 |
CareSource Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | None | $234.42 | $234.42 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $426.58 Typical High $2,398.83 | Facility | None | $245.47 | $426.58 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $512.86 | Professional | None | $223.87 | $338.84 | $512.86 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $245.47 Median $416.87 Typical High $2,398.83 | Facility | None | $245.47 | $416.87 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $512.86 | Professional | None | $223.87 | $338.84 | $512.86 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $269.15 Typical High $489.78 | Professional | None | $27.54 | $269.15 | $489.78 |
SummaCare Setting Facility Modifier None Typical Low $134.90 Median $141.25 Typical High $158.49 | Facility | None | $134.90 | $141.25 | $158.49 |
SummaCare Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $436.52 | Professional | None | $204.17 | $309.03 | $436.52 |
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 $199.53 Median $281.84 Typical High $457.09 | Professional | None | $199.53 | $281.84 | $457.09 |
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 $109.65 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $109.65 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $43.65 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $251.19 Typical High $257.04 | Professional | 54 · Surgery only | $162.18 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $33.11 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $21.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $234.42 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $151.36 | $234.42 | $239.88 |
Where Ohio sits
The same service costs 3.6 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
$275
AK $912NJ $251
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.