How much rates vary
Facilitymedian $457 · 10th to 90th $79 to $3,548Professionalmedian $145 · 10th to 90th $93 to $240
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 $204.17 Median $489.78 Typical High $10,715.19 | Facility | None | $204.17 | $489.78 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $407.38 | Professional | None | $109.65 | $138.04 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $186.21 | Professional | None | $128.82 | $151.36 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $181.97 | Professional | None | $93.33 | $117.49 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $87.10 Typical High $151.36 | Facility | None | $66.07 | $87.10 | $151.36 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $223.87 | Professional | None | $144.54 | $181.97 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $93.33 Typical High $616.60 | Facility | None | $66.07 | $93.33 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $162.18 Typical High $251.19 | Professional | None | $131.83 | $162.18 | $251.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $66.07 Median $104.71 Typical High $794.33 | Facility | None | $66.07 | $104.71 | $794.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $131.83 Median $162.18 Typical High $257.04 | Professional | None | $131.83 | $162.18 | $257.04 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $223.87 | Professional | None | $89.13 | $141.25 | $223.87 |
SummaCare Setting Facility Modifier None Typical Low $39.81 Median $41.69 Typical High $46.77 | Facility | None | $39.81 | $41.69 | $46.77 |
SummaCare Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $204.17 | Professional | None | $112.20 | $151.36 | $204.17 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $251.19 | Professional | None | $93.33 | $151.36 | $251.19 |
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 $54.95 Median $69.18 Typical High $81.28 | Professional | 52 · Reduced service | $54.95 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $27.54 Typical High $32.36 | Professional | 53 · Discontinued | $21.88 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $102.33 Typical High $123.03 | Professional | 54 · Surgery only | $83.18 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.42 Typical High $24.55 | Professional | 55 · Aftercare only | $16.60 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.80 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.96 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $95.50 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $77.62 | $95.50 | $114.82 |
Where Ohio sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 39th of 51
$151
AK $501FL $129
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.