How much rates vary
Facilitymedian $2,188 · 10th to 90th $589 to $7,244Professionalmedian $398 · 10th to 90th $251 to $617
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 $870.96 Median $2,691.53 Typical High $10,964.78 | Facility | None | $870.96 | $2,691.53 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $512.86 | Professional | None | $316.23 | $426.58 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $2,187.76 Typical High $7,079.46 | Facility | None | $660.69 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $537.03 | Professional | None | $288.40 | $354.81 | $537.03 |
CareSource Setting Facility Modifier None Typical Low $398.11 Median $2,818.38 Typical High $3,630.78 | Facility | None | $398.11 | $2,818.38 | $3,630.78 |
CareSource Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $380.19 | Professional | None | $338.84 | $338.84 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $2,818.38 Typical High $4,570.88 | Facility | None | $489.78 | $2,818.38 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $660.69 | Professional | None | $338.84 | $457.09 | $660.69 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $2,884.03 Typical High $4,466.84 | Facility | None | $512.86 | $2,884.03 | $4,466.84 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $645.65 | Professional | None | $338.84 | $457.09 | $645.65 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $398.11 Typical High $630.96 | Professional | None | $31.62 | $398.11 | $630.96 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $549.54 | Professional | None | $309.03 | $446.68 | $549.54 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $630.96 | Professional | None | $302.00 | $407.38 | $630.96 |
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 $158.49 Median $213.80 Typical High $223.87 | Professional | 52 · Reduced service | $158.49 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $85.11 Typical High $89.13 | Professional | 53 · Discontinued | $63.10 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $323.59 Typical High $338.84 | Professional | 54 · Surgery only | $239.88 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $64.57 Typical High $67.61 | Professional | 55 · Aftercare only | $47.86 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $42.66 Typical High $44.67 | Professional | 56 · Pre-op care only | $31.62 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $302.00 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $223.87 | $302.00 | $316.23 |
Where Ohio sits
The same service costs 4.0 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· 42nd of 51
$407
AK $1,318NJ $331
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.