How much rates vary
Facilitymedian $871 · 10th to 90th $178 to $5,248Professionalmedian $200 · 10th to 90th $135 to $309
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 $512.86 Median $3,235.94 Typical High $12,589.25 | Facility | None | $512.86 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $251.19 | Professional | None | $138.04 | $218.78 | $251.19 |
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 $131.83 Median $190.55 Typical High $288.40 | Professional | None | $131.83 | $190.55 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $144.54 Median $169.82 Typical High $190.55 | Facility | None | $144.54 | $169.82 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $162.18 | Professional | None | $144.54 | $144.54 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $288.40 Typical High $1,479.11 | Facility | None | $162.18 | $288.40 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $346.74 | Professional | None | $144.54 | $229.09 | $346.74 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $162.18 Median $288.40 Typical High $1,479.11 | Facility | None | $162.18 | $288.40 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $338.84 | Professional | None | $144.54 | $229.09 | $338.84 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $323.59 | Professional | None | $141.25 | $204.17 | $323.59 |
SummaCare Setting Facility Modifier None Typical Low $85.11 Median $89.13 Typical High $102.33 | Facility | None | $85.11 | $89.13 | $102.33 |
SummaCare Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $269.15 | Professional | None | $128.82 | $194.98 | $269.15 |
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 $128.82 Median $199.53 Typical High $309.03 | Professional | None | $128.82 | $199.53 | $309.03 |
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 $69.18 Median $109.65 Typical High $112.20 | Professional | 52 · Reduced service | $69.18 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $43.65 Typical High $44.67 | Professional | 53 · Discontinued | $27.54 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $162.18 Typical High $169.82 | Professional | 54 · Surgery only | $104.71 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $32.36 Typical High $33.88 | Professional | 55 · Aftercare only | $20.89 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $21.88 Typical High $22.39 | Professional | 56 · Pre-op care only | $13.80 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $151.36 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $97.72 | $151.36 | $158.49 |
Where Ohio sits
The same service costs 3.5 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· 43rd of 51
$204
AK $575NJ $166
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.