How much rates vary
Facilitymedian $1,738 · 10th to 90th $513 to $7,586Professionalmedian $288 · 10th to 90th $195 to $501
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 $602.56 Median $2,630.27 Typical High $12,022.64 | Facility | None | $602.56 | $2,630.27 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $741.31 | Professional | None | $218.78 | $218.78 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $1,584.89 Typical High $7,585.78 | Facility | None | $549.54 | $1,584.89 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $524.81 | Professional | None | $288.40 | $371.54 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $269.15 Median $1,548.82 Typical High $1,995.26 | Facility | None | $269.15 | $1,548.82 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $263.03 | Professional | None | $229.09 | $229.09 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,584.89 Typical High $2,454.71 | Facility | None | $389.05 | $1,584.89 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $575.44 | Professional | None | $218.78 | $239.88 | $575.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $1,584.89 Typical High $2,398.83 | Facility | None | $389.05 | $1,584.89 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $575.44 | Professional | None | $218.78 | $239.88 | $575.44 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $316.23 | Professional | None | $165.96 | $213.80 | $316.23 |
SummaCare Setting Facility Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $1,995.26 | Facility | None | $1,659.59 | $1,737.80 | $1,995.26 |
SummaCare Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | None | $208.93 | $208.93 | $245.47 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $186.21 Median $346.74 Typical High $457.09 | Professional | None | $186.21 | $346.74 | $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 $109.65 Median $109.65 Typical High $186.21 | Professional | 52 · Reduced service | $109.65 | $109.65 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $74.13 | Professional | 53 · Discontinued | $43.65 | $43.65 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $275.42 | Professional | 54 · Surgery only | $165.96 | $165.96 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $54.95 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $37.15 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $154.88 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $154.88 | $154.88 | $257.04 |
Where Ohio sits
The same service costs 4.6 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· 38th of 51
$309
AK $891UT $195
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.