How much rates vary
Facilitymedian $1,514 · 10th to 90th $457 to $5,754Professionalmedian $234 · 10th to 90th $170 to $372
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 $478.63 Median $1,995.26 Typical High $10,964.78 | Facility | None | $478.63 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $1,995.26 | Professional | None | $181.97 | $234.42 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $1,174.90 Typical High $4,466.84 | Facility | None | $467.74 | $1,174.90 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $338.84 | Professional | None | $154.88 | $190.55 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $1,621.81 Typical High $2,089.30 | Facility | None | $229.09 | $1,621.81 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,659.59 Typical High $2,630.27 | Facility | None | $363.08 | $1,659.59 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $446.68 | Professional | None | $177.83 | $245.47 | $446.68 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $1,659.59 Typical High $2,570.40 | Facility | None | $389.05 | $1,659.59 | $2,570.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $457.09 | Professional | None | $177.83 | $245.47 | $457.09 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $338.84 | Professional | None | $173.78 | $245.47 | $338.84 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,071.52 | Facility | None | $891.25 | $933.25 | $1,071.52 |
SummaCare Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $316.23 | Professional | None | $169.82 | $239.88 | $316.23 |
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 $169.82 Median $229.09 Typical High $457.09 | Professional | None | $169.82 | $229.09 | $457.09 |
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 $91.20 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $91.20 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $36.31 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $177.83 Typical High $177.83 | Professional | 54 · Surgery only | $134.90 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $26.92 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $18.20 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $165.96 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $125.89 | $165.96 | $165.96 |
Where Ohio sits
The same service costs 4.4 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· 44th of 51
$240
AK $871UT $200
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.