How much rates vary
Facilitymedian $1,622 · 10th to 90th $468 to $5,888Professionalmedian $331 · 10th to 90th $93 to $525
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 $630.96 Median $2,454.71 Typical High $11,220.18 | Facility | None | $630.96 | $2,454.71 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $3,548.13 | Professional | None | $346.74 | $346.74 | $3,548.13 |
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 $218.78 Median $257.04 Typical High $478.63 | Professional | None | $218.78 | $257.04 | $478.63 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $1,621.81 Typical High $2,089.30 | Facility | None | $426.58 | $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 $309.03 Median $416.87 Typical High $660.69 | Professional | None | $309.03 | $416.87 | $660.69 |
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 $309.03 Median $416.87 Typical High $660.69 | Professional | None | $309.03 | $416.87 | $660.69 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $323.59 Typical High $489.78 | Professional | None | $79.43 | $323.59 | $489.78 |
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 $323.59 Median $323.59 Typical High $478.63 | Professional | None | $323.59 | $323.59 | $478.63 |
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 $288.40 Median $363.08 Typical High $870.96 | Professional | None | $288.40 | $363.08 | $870.96 |
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 $173.78 Median $173.78 Typical High $223.87 | Professional | 52 · Reduced service | $173.78 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $89.13 | Professional | 53 · Discontinued | $69.18 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $338.84 | Professional | 54 · Surgery only | $257.04 | $257.04 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $67.61 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $316.23 |
Where Ohio sits
The same service costs 8.5 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· 47th of 51
$347
OK $2,138UT $251
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.