How much rates vary
Facilitymedian $3,090 · 10th to 90th $537 to $12,023Professionalmedian $427 · 10th to 90th $257 to $617
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 $512.86 Median $10,232.93 Typical High $13,803.84 | Facility | None | $512.86 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $1,230.27 | Professional | None | $426.58 | $426.58 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $6,606.93 Typical High $13,803.84 | Facility | None | $891.25 | $6,606.93 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $588.84 | Professional | None | $295.12 | $426.58 | $588.84 |
CareSource Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $512.86 | Professional | None | $457.09 | $457.09 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $758.58 | Professional | None | $416.87 | $457.09 | $758.58 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $758.58 | Professional | None | $416.87 | $457.09 | $758.58 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $371.54 Typical High $575.44 | Professional | None | $56.23 | $371.54 | $575.44 |
SummaCare Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $489.78 | Professional | None | $416.87 | $416.87 | $489.78 |
United Setting Facility Modifier None Typical Low $501.19 Median $891.25 Typical High $4,677.35 | Facility | None | $501.19 | $891.25 | $4,677.35 |
United Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $707.95 | Professional | None | $363.08 | $457.09 | $707.95 |
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 $213.80 Median $213.80 Typical High $288.40 | Professional | 52 · Reduced service | $213.80 | $213.80 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $114.82 | Professional | 53 · Discontinued | $85.11 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $426.58 | Professional | 54 · Surgery only | $323.59 | $323.59 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $85.11 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $398.11 |
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· 43rd of 51
$427
AK $1,738UT $316
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.