How much rates vary
Facilitymedian $1,023 · 10th to 90th $331 to $5,888Professionalmedian $339 · 10th to 90th $79 to $575
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 $758.58 Median $3,235.94 Typical High $12,589.25 | Facility | None | $758.58 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $1,445.44 | Professional | None | $338.84 | $426.58 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $512.86 | Professional | None | $239.88 | $331.13 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $346.74 Typical High $407.38 | Facility | None | $263.03 | $346.74 | $407.38 |
CareSource Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $446.68 Typical High $2,398.83 | Facility | None | $281.84 | $446.68 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $645.65 | Professional | None | $302.00 | $416.87 | $645.65 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $281.84 Median $446.68 Typical High $2,398.83 | Facility | None | $281.84 | $446.68 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $616.60 | Professional | None | $288.40 | $416.87 | $616.60 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $275.42 Typical High $501.19 | Professional | None | $33.88 | $275.42 | $501.19 |
SummaCare Setting Facility Modifier None Typical Low $151.36 Median $158.49 Typical High $181.97 | Facility | None | $151.36 | $158.49 | $181.97 |
SummaCare Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $512.86 | Professional | None | $302.00 | $436.52 | $512.86 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $5,888.44 | Facility | None | $691.83 | $1,445.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $645.65 | Professional | None | $288.40 | $371.54 | $645.65 |
7 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 $169.82 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $169.82 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $67.61 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $251.19 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $50.12 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.88 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $234.42 | $302.00 | $302.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $489.78 Typical High $758.58 | Professional | 50 · Both sides | $354.81 | $489.78 | $758.58 |
Where Ohio sits
The same service costs 5.0 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· 47th of 51
$347
AK $1,380UT $275
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.