How much rates vary
Facilitymedian $1,622 · 10th to 90th $661 to $9,120Professionalmedian $380 · 10th to 90th $102 to $661
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 $1,288.25 Typical High $12,302.69 | Facility | None | $630.96 | $1,288.25 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $1,548.82 | Professional | None | $302.00 | $354.81 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,202.26 Typical High $4,786.30 | Facility | None | $645.65 | $1,202.26 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $549.54 | Professional | None | $275.42 | $338.84 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $467.74 Median $1,621.81 Typical High $2,089.30 | Facility | None | $467.74 | $1,621.81 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,862.09 Typical High $3,388.44 | Facility | None | $758.58 | $1,862.09 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $758.58 | Professional | None | $363.08 | $416.87 | $758.58 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $794.33 Median $1,862.09 Typical High $3,388.44 | Facility | None | $794.33 | $1,862.09 | $3,388.44 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $776.25 | Professional | None | $363.08 | $416.87 | $776.25 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $371.54 Typical High $588.84 | Professional | None | $79.43 | $371.54 | $588.84 |
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 $346.74 Median $426.58 Typical High $562.34 | Professional | None | $346.74 | $426.58 | $562.34 |
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 $331.13 Median $426.58 Typical High $758.58 | Professional | None | $331.13 | $426.58 | $758.58 |
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 $151.36 Median $173.78 Typical High $190.55 | Professional | 52 · Reduced service | $151.36 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $69.18 Typical High $75.86 | Professional | 53 · Discontinued | $60.26 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $257.04 Typical High $288.40 | Professional | 54 · Surgery only | $229.09 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $51.29 Typical High $57.54 | Professional | 55 · Aftercare only | $45.71 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $34.67 Typical High $38.02 | Professional | 56 · Pre-op care only | $30.20 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $239.88 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $213.80 | $239.88 | $269.15 |
Where Ohio sits
The same service costs 4.3 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· 48th of 51
$398
AK $1,380UT $324
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.