How much rates vary
Facilitymedian $1,122 · 10th to 90th $490 to $5,248Professionalmedian $347 · 10th to 90th $56 to $603
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 $338.84 Median $1,000.00 Typical High $10,232.93 | Facility | None | $338.84 | $1,000.00 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $1,174.90 | Professional | None | $234.42 | $338.84 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $457.09 | Professional | None | $245.47 | $309.03 | $457.09 |
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 $199.53 Median $380.19 Typical High $676.08 | Professional | None | $199.53 | $380.19 | $676.08 |
CareSource Setting Facility Modifier None Typical Low $281.84 Median $933.25 Typical High $1,202.26 | Facility | None | $281.84 | $933.25 | $1,202.26 |
CareSource Setting Professional Modifier None Typical Low $371.54 Median $389.05 Typical High $416.87 | Professional | None | $371.54 | $389.05 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,071.52 Typical High $1,995.26 | Facility | None | $512.86 | $1,071.52 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $724.44 | Professional | None | $218.78 | $338.84 | $724.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $3,019.95 | Facility | None | $524.81 | $1,122.02 | $3,019.95 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $724.44 | Professional | None | $218.78 | $338.84 | $724.44 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $331.13 Typical High $489.78 | Professional | None | $38.02 | $331.13 | $489.78 |
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 $218.78 Median $346.74 Typical High $537.03 | Professional | None | $218.78 | $346.74 | $537.03 |
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 $213.80 Median $371.54 Typical High $676.08 | Professional | None | $213.80 | $371.54 | $676.08 |
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 $117.49 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $117.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $46.77 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $177.83 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $35.48 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $23.44 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $234.42 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $165.96 | $234.42 | $234.42 |
Where Ohio sits
The same service costs 4.6 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· 47th of 51
$363
AK $1,259UT $275
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.