How much rates vary
Facilitymedian $1,622 · 10th to 90th $525 to $5,888Professionalmedian $209 · 10th to 90th $158 to $372
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 $2,691.53 Typical High $10,964.78 | Facility | None | $512.86 | $2,691.53 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $2,630.27 | Professional | None | $186.21 | $208.93 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $1,230.27 Typical High $4,466.84 | Facility | None | $537.03 | $1,230.27 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $346.74 | Professional | None | $151.36 | $204.17 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $1,584.89 Typical High $2,089.30 | Facility | None | $229.09 | $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 $177.83 Median $223.87 Typical High $416.87 | Professional | None | $177.83 | $223.87 | $416.87 |
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 $177.83 Median $223.87 Typical High $436.52 | Professional | None | $177.83 | $223.87 | $436.52 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $309.03 | Professional | None | $138.04 | $204.17 | $309.03 |
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 $173.78 Median $218.78 Typical High $288.40 | Professional | None | $173.78 | $218.78 | $288.40 |
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 $181.97 Median $229.09 Typical High $426.58 | Professional | None | $181.97 | $229.09 | $426.58 |
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 $93.33 Median $104.71 Typical High $117.49 | Professional | 52 · Reduced service | $93.33 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $41.69 Typical High $46.77 | Professional | 53 · Discontinued | $37.15 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $158.49 Typical High $177.83 | Professional | 54 · Surgery only | $138.04 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $31.62 Typical High $35.48 | Professional | 55 · Aftercare only | $27.54 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $20.89 Typical High $23.44 | Professional | 56 · Pre-op care only | $18.62 | $20.89 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $147.91 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $128.82 | $147.91 | $165.96 |
Where Ohio sits
The same service costs 5.9 times more in Oklahoma 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· 47th of 51
$224
OK $1,175UT $200
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.