How much rates vary
Facilitymedian $1,950 · 10th to 90th $646 to $7,762Professionalmedian $676 · 10th to 90th $91 to $1,000
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 $1,949.84 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,949.84 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $4,786.30 | Professional | None | $691.83 | $691.83 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $7,585.78 | Facility | None | $602.56 | $1,513.56 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $1,096.48 | Professional | None | $575.44 | $676.08 | $1,096.48 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $1,584.89 Typical High $2,089.30 | Facility | None | $831.76 | $1,584.89 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $4,677.35 | Facility | None | $588.84 | $1,862.09 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,412.54 | Professional | None | $602.56 | $724.44 | $1,412.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $4,677.35 | Facility | None | $588.84 | $1,862.09 | $4,677.35 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,412.54 | Professional | None | $602.56 | $724.44 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $630.96 Typical High $870.96 | Professional | None | $79.43 | $630.96 | $870.96 |
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 $630.96 Median $630.96 Typical High $954.99 | Professional | None | $630.96 | $630.96 | $954.99 |
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 $630.96 Median $776.25 Typical High $1,548.82 | Professional | None | $630.96 | $776.25 | $1,548.82 |
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 $346.74 Median $346.74 Typical High $1,318.26 | Professional | 52 · Reduced service | $346.74 | $346.74 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $537.03 | Professional | 53 · Discontinued | $138.04 | $138.04 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $1,995.26 | Professional | 54 · Surgery only | $524.81 | $524.81 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $398.11 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $269.15 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $1,862.09 |
Where Ohio sits
The same service costs 4.2 times more in Oklahoma than in Kentucky. 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.
Physician feeFacility fee
OK $7,369KY $1,773
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.