How much rates vary
Facilitymedian $1,660 · 10th to 90th $603 to $8,710Professionalmedian $933 · 10th to 90th $141 to $1,549
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 $1,737.80 Median $9,332.54 Typical High $12,589.25 | Facility | None | $1,737.80 | $9,332.54 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $7,079.46 | Professional | None | $933.25 | $933.25 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,288.25 Typical High $4,677.35 | Facility | None | $524.81 | $1,288.25 | $4,677.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,445.44 | Professional | None | $630.96 | $741.31 | $1,445.44 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $954.99 Typical High $1,288.25 | Facility | None | $630.96 | $954.99 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,584.89 Typical High $2,691.53 | Facility | None | $549.54 | $1,584.89 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $2,137.96 | Professional | None | $954.99 | $1,348.96 | $2,137.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $1,584.89 Typical High $2,691.53 | Facility | None | $549.54 | $1,584.89 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,348.96 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $891.25 Typical High $1,479.11 | Professional | None | $123.03 | $891.25 | $1,479.11 |
SummaCare Setting Facility Modifier None Typical Low $758.58 Median $794.33 Typical High $912.01 | Facility | None | $758.58 | $794.33 | $912.01 |
SummaCare Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,548.82 | Professional | None | $1,047.13 | $1,047.13 | $1,548.82 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $8,709.64 | Facility | None | $851.14 | $2,630.27 | $8,709.64 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $2,570.40 | Professional | None | $870.96 | $1,122.02 | $2,570.40 |
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 $467.74 Median $467.74 Typical High $1,737.80 | Professional | 52 · Reduced service | $467.74 | $467.74 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $691.83 | Professional | 53 · Discontinued | $190.55 | $190.55 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $2,630.27 | Professional | 54 · Surgery only | $707.95 | $707.95 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $524.81 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $346.74 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $2,454.71 |
Where Ohio sits
The same service costs 6.6 times more in Alaska than in Texas. 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· 46th of 51
$955
AK $4,266TX $646
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.