How much rates vary
Facilitymedian $1,820 · 10th to 90th $537 to $6,607Professionalmedian $398 · 10th to 90th $55 to $646
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 $707.95 Median $4,365.16 Typical High $12,589.25 | Facility | None | $707.95 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $3,548.13 | Professional | None | $288.40 | $389.05 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,202.26 Typical High $4,466.84 | Facility | None | $524.81 | $1,202.26 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $724.44 | Professional | None | $251.19 | $426.58 | $724.44 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $1,584.89 Typical High $2,089.30 | Facility | None | $346.74 | $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 $269.15 Median $398.11 Typical High $870.96 | Professional | None | $269.15 | $398.11 | $870.96 |
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 $269.15 Median $398.11 Typical High $891.25 | Professional | None | $269.15 | $398.11 | $891.25 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $407.38 Typical High $588.84 | Professional | None | $38.90 | $407.38 | $588.84 |
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 $263.03 Median $398.11 Typical High $512.86 | Professional | None | $263.03 | $398.11 | $512.86 |
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 $263.03 Median $426.58 Typical High $758.58 | Professional | None | $263.03 | $426.58 | $758.58 |
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 $141.25 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $141.25 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $57.54 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $213.80 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $42.66 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $28.84 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $269.15 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $199.53 | $269.15 | $269.15 |
Where Ohio sits
The same service costs 4.8 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· 46th of 51
$417
AK $1,549UT $324
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.