How much rates vary
Facilitymedian $562 · 10th to 90th $151 to $3,715Professionalmedian $204 · 10th to 90th $66 to $324
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 $177.83 Median $251.19 Typical High $281.84 | Professional | None | $177.83 | $251.19 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $831.76 Typical High $3,311.31 | Facility | None | $371.54 | $831.76 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $288.40 | Professional | None | $144.54 | $186.21 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $263.03 Typical High $346.74 | Facility | None | $218.78 | $263.03 | $346.74 |
CareSource Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $208.93 | Professional | None | $186.21 | $186.21 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $398.11 Typical High $1,479.11 | Facility | None | $281.84 | $398.11 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $380.19 | Professional | None | $177.83 | $251.19 | $380.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $288.40 Median $398.11 Typical High $1,479.11 | Facility | None | $288.40 | $398.11 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $363.08 | Professional | None | $177.83 | $251.19 | $363.08 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $190.55 Typical High $323.59 | Professional | None | $30.20 | $190.55 | $323.59 |
SummaCare Setting Facility Modifier None Typical Low $151.36 Median $158.49 Typical High $181.97 | Facility | None | $151.36 | $158.49 | $181.97 |
SummaCare Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $302.00 | Professional | None | $162.18 | $245.47 | $302.00 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $346.74 | Professional | None | $158.49 | $223.87 | $346.74 |
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 $89.13 Median $125.89 Typical High $128.82 | Professional | 52 · Reduced service | $89.13 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $50.12 Typical High $51.29 | Professional | 53 · Discontinued | $35.48 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $190.55 Typical High $194.98 | Professional | 54 · Surgery only | $131.83 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $38.02 Typical High $38.90 | Professional | 55 · Aftercare only | $26.30 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $25.12 Typical High $25.70 | Professional | 56 · Pre-op care only | $17.78 | $25.12 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $177.83 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $123.03 | $177.83 | $181.97 |
Where Ohio sits
The same service costs 4.2 times more in Alaska than in Texas. 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
$209
AK $741TX $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.