How much rates vary
Facilitymedian $1,479 · 10th to 90th $417 to $4,786Professionalmedian $617 · 10th to 90th $490 to $1,047
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 $1,737.80 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,737.80 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $4,168.69 | Professional | None | $562.34 | $562.34 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $489.78 Median $1,000.00 Typical High $4,570.88 | Facility | None | $489.78 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $1,000.00 | Professional | None | $478.63 | $575.44 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $870.96 Typical High $1,479.11 | Professional | 50 · Both sides | $724.44 | $870.96 | $1,479.11 |
CareSource Setting Facility Modifier None Typical Low $691.83 Median $1,584.89 Typical High $2,089.30 | Facility | None | $691.83 | $1,584.89 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,659.59 Typical High $2,630.27 | Facility | None | $389.05 | $1,659.59 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $1,148.15 | Professional | None | $512.86 | $616.60 | $1,148.15 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $398.11 Median $1,659.59 Typical High $2,570.40 | Facility | None | $398.11 | $1,659.59 | $2,570.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $1,148.15 | Professional | None | $512.86 | $616.60 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $831.76 | Professional | None | $489.78 | $630.96 | $831.76 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,047.13 | Facility | None | $891.25 | $933.25 | $1,047.13 |
SummaCare Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $812.83 | Professional | None | $512.86 | $512.86 | $812.83 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,388.44 | Facility | None | $363.08 | $691.83 | $3,388.44 |
United Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,348.96 | Professional | None | $537.03 | $660.69 | $1,348.96 |
5 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 $281.84 Median $281.84 Typical High $954.99 | Professional | 52 · Reduced service | $281.84 | $281.84 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $380.19 | Professional | 53 · Discontinued | $112.20 | $112.20 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $1,412.54 | Professional | 54 · Surgery only | $416.87 | $416.87 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $288.40 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $190.55 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $190.55 |
Where Ohio sits
The same service costs 3.9 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
$631
AK $2,239UT $575
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.