How much rates vary
Facilitymedian $741 · 10th to 90th $141 to $4,786Professionalmedian $166 · 10th to 90th $107 to $302
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 $234.42 Median $616.60 Typical High $10,715.19 | Facility | None | $234.42 | $616.60 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $616.60 | Professional | None | $128.82 | $181.97 | $616.60 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $234.42 | Professional | None | $100.00 | $125.89 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $123.03 Median $158.49 Typical High $162.18 | Facility | None | $123.03 | $158.49 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $204.17 Typical High $2,398.83 | Facility | None | $120.23 | $204.17 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $309.03 | Professional | None | $123.03 | $173.78 | $309.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $120.23 Median $204.17 Typical High $2,398.83 | Facility | None | $120.23 | $204.17 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $338.84 | Professional | None | $123.03 | $177.83 | $338.84 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $309.03 | Professional | None | $131.83 | $204.17 | $309.03 |
SummaCare Setting Facility Modifier None Typical Low $64.57 Median $67.61 Typical High $77.62 | Facility | None | $64.57 | $67.61 | $77.62 |
SummaCare Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $239.88 | Professional | None | $120.23 | $181.97 | $239.88 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $331.13 | Professional | None | $114.82 | $154.88 | $331.13 |
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 $64.57 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $64.57 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $25.70 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $134.90 Typical High $138.04 | Professional | 54 · Surgery only | $95.50 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $26.92 Typical High $27.54 | Professional | 55 · Aftercare only | $19.05 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $12.88 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $125.89 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $89.13 | $125.89 | $128.82 |
Where Ohio sits
The same service costs 3.9 times more in Alaska 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.
Ohio· 38th of 51
$178
AK $550KY $141
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.