How much rates vary
Facilitymedian $1,380 · 10th to 90th $537 to $5,248Professionalmedian $178 · 10th to 90th $120 to $295
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 $1,479.11 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,479.11 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $4,365.16 | Professional | None | $177.83 | $177.83 | $4,365.16 |
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 $134.90 Median $169.82 Typical High $275.42 | Professional | None | $134.90 | $169.82 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $1,174.90 Typical High $1,513.56 | Facility | None | $223.87 | $1,174.90 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,348.96 Typical High $2,398.83 | Facility | None | $549.54 | $1,348.96 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $354.81 | Professional | None | $169.82 | $223.87 | $354.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $1,348.96 Typical High $2,398.83 | Facility | None | $549.54 | $1,348.96 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $354.81 | Professional | None | $169.82 | $223.87 | $354.81 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $257.04 | Professional | None | $104.71 | $165.96 | $257.04 |
SummaCare Setting Facility Modifier None Typical Low $645.65 Median $676.08 Typical High $758.58 | Facility | None | $645.65 | $676.08 | $758.58 |
SummaCare Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $245.47 | Professional | None | $162.18 | $162.18 | $245.47 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,786.30 | Facility | None | $501.19 | $977.24 | $4,786.30 |
United Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $446.68 | Professional | None | $158.49 | $199.53 | $446.68 |
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 $87.10 Median $87.10 Typical High $117.49 | Professional | 52 · Reduced service | $87.10 | $87.10 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $46.77 | Professional | 53 · Discontinued | $35.48 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $173.78 | Professional | 54 · Surgery only | $131.83 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $34.67 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $23.44 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $123.03 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $123.03 | $123.03 | $162.18 |
Where Ohio sits
The same service costs 8.7 times more in Oklahoma 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· 48th of 51
$191
OK $1,349UT $155
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.