How much rates vary
Facilitymedian $603 · 10th to 90th $302 to $3,715Professionalmedian $214 · 10th to 90th $66 to $437
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 $812.83 Typical High $12,589.25 | Facility | None | $446.68 | $812.83 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $295.12 Typical High $446.68 | Professional | None | $177.83 | $295.12 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $257.04 | Professional | None | $87.10 | $134.90 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $229.09 Typical High $302.00 | Facility | None | $223.87 | $229.09 | $302.00 |
CareSource Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $213.80 | Professional | None | $190.55 | $190.55 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $446.68 Typical High $2,398.83 | Facility | None | $281.84 | $446.68 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $426.58 | Professional | None | $177.83 | $281.84 | $426.58 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $281.84 Median $446.68 Typical High $2,398.83 | Facility | None | $281.84 | $446.68 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $416.87 | Professional | None | $177.83 | $288.40 | $416.87 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $302.00 Typical High $489.78 | Professional | None | $30.90 | $302.00 | $489.78 |
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 $190.55 Median $288.40 Typical High $407.38 | Professional | None | $190.55 | $288.40 | $407.38 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,311.31 | Facility | None | $363.08 | $691.83 | $3,311.31 |
United Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $371.54 | Professional | None | $125.89 | $199.53 | $371.54 |
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 $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $89.13 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $58.88 Typical High $60.26 | Professional | 53 · Discontinued | $35.48 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $131.83 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $26.92 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $29.51 Typical High $30.20 | Professional | 56 · Pre-op care only | $17.78 | $29.51 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $208.93 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $123.03 | $208.93 | $208.93 |
Where Ohio sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$219
AK $741KY $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.