How much rates vary
Facilitymedian $1,622 · 10th to 90th $631 to $7,762Professionalmedian $575 · 10th to 90th $91 to $871
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 $2,290.87 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,290.87 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $2,454.71 | Professional | None | $616.60 | $616.60 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,318.26 Typical High $4,786.30 | Facility | None | $575.44 | $1,318.26 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $812.83 | Professional | None | $436.52 | $512.86 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $1,348.96 Typical High $1,737.80 | Facility | None | $776.25 | $1,348.96 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $741.31 | Professional | None | $645.65 | $645.65 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $2,630.27 | Facility | None | $602.56 | $1,513.56 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $1,000.00 | Professional | None | $588.84 | $645.65 | $1,000.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $2,570.40 | Facility | None | $602.56 | $1,513.56 | $2,570.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $977.24 | Professional | None | $588.84 | $645.65 | $977.24 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $537.03 Typical High $831.76 | Professional | None | $64.57 | $537.03 | $831.76 |
SummaCare Setting Facility Modifier None Typical Low $741.31 Median $776.25 Typical High $870.96 | Facility | None | $741.31 | $776.25 | $870.96 |
SummaCare Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $724.44 | Professional | None | $616.60 | $616.60 | $724.44 |
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 $489.78 Median $630.96 Typical High $977.24 | Professional | None | $489.78 | $630.96 | $977.24 |
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 $309.03 Median $309.03 Typical High $407.38 | Professional | 52 · Reduced service | $309.03 | $309.03 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $162.18 | Professional | 53 · Discontinued | $123.03 | $123.03 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $602.56 | Professional | 54 · Surgery only | $457.09 | $457.09 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $123.03 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $81.28 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $562.34 |
Where Ohio sits
The same service costs 5.6 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· 45th of 51
$575
AK $2,512TX $447
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.