How much rates vary
Facilitymedian $1,230 · 10th to 90th $617 to $8,128Professionalmedian $339 · 10th to 90th $229 to $550
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 $602.56 Median $5,128.61 Typical High $12,589.25 | Facility | None | $602.56 | $5,128.61 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $8,128.31 | Professional | None | $331.13 | $416.87 | $8,128.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,230.27 Typical High $4,786.30 | Facility | None | $630.96 | $1,230.27 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $524.81 | Professional | None | $263.03 | $323.59 | $524.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $489.78 Typical High $794.33 | Professional | 50 · Both sides | $389.05 | $489.78 | $794.33 |
CareSource Setting Facility Modifier None Typical Low $398.11 Median $933.25 Typical High $1,202.26 | Facility | None | $398.11 | $933.25 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,071.52 Typical High $2,951.21 | Facility | None | $741.31 | $1,071.52 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $660.69 | Professional | None | $288.40 | $346.74 | $660.69 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $1,071.52 Typical High $2,951.21 | Facility | None | $741.31 | $1,071.52 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $660.69 | Professional | None | $288.40 | $346.74 | $660.69 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $338.84 Typical High $467.74 | Professional | None | $47.86 | $338.84 | $467.74 |
SummaCare Setting Facility Modifier None Typical Low $512.86 Median $537.03 Typical High $616.60 | Facility | None | $512.86 | $537.03 | $616.60 |
SummaCare Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $457.09 | Professional | None | $302.00 | $302.00 | $457.09 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $5,888.44 | Facility | None | $691.83 | $1,445.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $295.12 Median $363.08 Typical High $741.31 | Professional | None | $295.12 | $363.08 | $741.31 |
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 $165.96 Median $165.96 Typical High $562.34 | Professional | 52 · Reduced service | $165.96 | $165.96 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $223.87 | Professional | 53 · Discontinued | $66.07 | $66.07 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $851.14 | Professional | 54 · Surgery only | $251.19 | $251.19 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $169.82 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $112.20 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $794.33 |
Where Ohio sits
The same service costs 5.1 times more in Oklahoma than in Montana. 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 $5,094MT $991
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.