How much rates vary
Facilitymedian $2,512 · 10th to 90th $603 to $7,943Professionalmedian $288 · 10th to 90th $204 to $427
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 $524.81 Median $4,168.69 Typical High $10,964.78 | Facility | None | $524.81 | $4,168.69 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $794.33 | Professional | None | $288.40 | $288.40 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $302.00 Typical High $331.13 | Professional | None | $295.12 | $302.00 | $331.13 |
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 $239.88 Median $281.84 Typical High $407.38 | Professional | None | $239.88 | $281.84 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $2,818.38 Typical High $3,630.78 | Facility | None | $363.08 | $2,818.38 | $3,630.78 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $295.12 Typical High $426.58 | Professional | None | $269.15 | $295.12 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,884.03 Typical High $4,897.79 | Facility | None | $602.56 | $2,884.03 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $524.81 | Professional | None | $275.42 | $295.12 | $524.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $616.60 Median $2,884.03 Typical High $5,495.41 | Facility | None | $616.60 | $2,884.03 | $5,495.41 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $524.81 | Professional | None | $275.42 | $295.12 | $524.81 |
Molina Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $371.54 | Professional | None | $177.83 | $245.47 | $371.54 |
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 $263.03 Median $263.03 Typical High $416.87 | Professional | None | $263.03 | $263.03 | $416.87 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,479.11 Typical High $6,165.95 | Facility | None | $691.83 | $1,479.11 | $6,165.95 |
United Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $457.09 | Professional | None | $239.88 | $302.00 | $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 $144.54 Median $144.54 Typical High $186.21 | Professional | 52 · Reduced service | $144.54 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $74.13 | Professional | 53 · Discontinued | $57.54 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $281.84 | Professional | 54 · Surgery only | $218.78 | $218.78 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $56.23 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $37.15 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $204.17 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $204.17 | $204.17 | $263.03 |
Where Ohio sits
The same service costs 5.5 times more in Alaska than in Utah. 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
$288
AK $1,202UT $219
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.