How much rates vary
Facilitymedian $1,862 · 10th to 90th $562 to $7,762Professionalmedian $407 · 10th to 90th $282 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 $1,513.56 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,513.56 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $4,786.30 | Professional | None | $398.11 | $398.11 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $7,585.78 | Facility | None | $562.34 | $1,513.56 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $602.56 | Professional | None | $302.00 | $371.54 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $1,584.89 Typical High $2,089.30 | Facility | None | $489.78 | $1,584.89 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,778.28 Typical High $2,630.27 | Facility | None | $489.78 | $1,778.28 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $812.83 | Professional | None | $354.81 | $426.58 | $812.83 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,778.28 Typical High $2,570.40 | Facility | None | $512.86 | $1,778.28 | $2,570.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $812.83 | Professional | None | $354.81 | $426.58 | $812.83 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $407.38 Typical High $562.34 | Professional | None | $57.54 | $407.38 | $562.34 |
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 $371.54 Median $371.54 Typical High $616.60 | Professional | None | $371.54 | $371.54 | $616.60 |
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 $371.54 Median $467.74 Typical High $954.99 | Professional | None | $371.54 | $467.74 | $954.99 |
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 $199.53 Median $199.53 Typical High $707.95 | Professional | 52 · Reduced service | $199.53 | $199.53 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $281.84 | Professional | 53 · Discontinued | $79.43 | $79.43 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $1,071.52 | Professional | 54 · Surgery only | $295.12 | $295.12 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $213.80 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $141.25 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $1,000.00 |
Where Ohio sits
The same service costs 6.2 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· 48th of 51
$427
AK $1,862UT $302
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.