How much rates vary
Facilitymedian $1,585 · 10th to 90th $646 to $8,511Professionalmedian $234 · 10th to 90th $162 to $339
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 $446.68 Median $5,128.61 Typical High $12,589.25 | Facility | None | $446.68 | $5,128.61 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $870.96 | Professional | None | $245.47 | $245.47 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,288.25 Typical High $4,786.30 | Facility | None | $630.96 | $1,288.25 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $338.84 | Professional | None | $199.53 | $234.42 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $1,348.96 Typical High $1,737.80 | Facility | None | $302.00 | $1,348.96 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $288.40 | Professional | None | $257.04 | $257.04 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,584.89 Typical High $2,951.21 | Facility | None | $741.31 | $1,584.89 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $245.47 Typical High $436.52 | Professional | None | $234.42 | $245.47 | $436.52 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $1,584.89 Typical High $2,951.21 | Facility | None | $741.31 | $1,584.89 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $234.42 Median $245.47 Typical High $436.52 | Professional | None | $234.42 | $245.47 | $436.52 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $288.40 | Professional | None | $141.25 | $194.98 | $288.40 |
SummaCare Setting Facility Modifier None Typical Low $758.58 Median $794.33 Typical High $912.01 | Facility | None | $758.58 | $794.33 | $912.01 |
SummaCare Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | None | $223.87 | $223.87 | $263.03 |
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 $199.53 Median $251.19 Typical High $380.19 | Professional | None | $199.53 | $251.19 | $380.19 |
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 $120.23 Median $120.23 Typical High $158.49 | Professional | 52 · Reduced service | $120.23 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $63.10 | Professional | 53 · Discontinued | $48.98 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $234.42 | Professional | 54 · Surgery only | $181.97 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $47.86 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $31.62 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $169.82 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $169.82 | $169.82 | $218.78 |
Where Ohio sits
The same service costs 6.0 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· 45th of 51
$240
AK $1,000UT $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.