How much rates vary
Facilitymedian $955 · 10th to 90th $398 to $4,898Professionalmedian $186 · 10th to 90th $135 to $282
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 $467.74 Median $3,235.94 Typical High $12,589.25 | Facility | None | $467.74 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $239.88 | Professional | None | $154.88 | $208.93 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $457.09 Median $1,148.15 Typical High $4,466.84 | Facility | None | $457.09 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $245.47 | Professional | None | $123.03 | $158.49 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $190.55 Median $630.96 Typical High $831.76 | Facility | None | $190.55 | $630.96 | $831.76 |
CareSource Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $181.97 | Professional | None | $162.18 | $162.18 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $707.95 Typical High $1,479.11 | Facility | None | $363.08 | $707.95 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $323.59 | Professional | None | $154.88 | $208.93 | $323.59 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $707.95 Typical High $1,479.11 | Facility | None | $389.05 | $707.95 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $316.23 | Professional | None | $154.88 | $208.93 | $316.23 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $288.40 | Professional | None | $141.25 | $190.55 | $288.40 |
SummaCare Setting Facility Modifier None Typical Low $338.84 Median $354.81 Typical High $407.38 | Facility | None | $338.84 | $354.81 | $407.38 |
SummaCare Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $251.19 | Professional | None | $141.25 | $204.17 | $251.19 |
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 $134.90 Median $186.21 Typical High $295.12 | Professional | None | $134.90 | $186.21 | $295.12 |
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 $77.62 Median $104.71 Typical High $107.15 | Professional | 52 · Reduced service | $77.62 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $41.69 Typical High $42.66 | Professional | 53 · Discontinued | $30.90 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $154.88 Typical High $158.49 | Professional | 54 · Surgery only | $114.82 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $30.90 Typical High $32.36 | Professional | 55 · Aftercare only | $22.91 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.89 Typical High $21.38 | Professional | 56 · Pre-op care only | $15.49 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $144.54 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $107.15 | $144.54 | $147.91 |
Where Ohio sits
The same service costs 4.2 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
$186
AK $646NJ $155
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.