How much rates vary
Facilitymedian $646 · 10th to 90th $200 to $8,128Professionalmedian $263 · 10th to 90th $54 to $437
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 $954.99 Median $8,128.31 Typical High $13,803.84 | Facility | None | $954.99 | $8,128.31 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $3,467.37 | Professional | None | $245.47 | $302.00 | $3,467.37 |
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 $229.09 Median $269.15 Typical High $407.38 | Professional | None | $229.09 | $269.15 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $165.96 Median $213.80 Typical High $295.12 | Facility | None | $165.96 | $213.80 | $295.12 |
CareSource Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $316.23 Typical High $1,479.11 | Facility | None | $177.83 | $316.23 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $524.81 | Professional | None | $213.80 | $316.23 | $524.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $177.83 Median $316.23 Typical High $1,479.11 | Facility | None | $177.83 | $316.23 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $512.86 | Professional | None | $213.80 | $309.03 | $512.86 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $190.55 Typical High $371.54 | Professional | None | $33.88 | $190.55 | $371.54 |
SummaCare Setting Facility Modifier None Typical Low $95.50 Median $100.00 Typical High $114.82 | Facility | None | $95.50 | $100.00 | $114.82 |
SummaCare Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $363.08 | Professional | None | $213.80 | $309.03 | $363.08 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,311.31 | Facility | None | $363.08 | $691.83 | $3,311.31 |
United Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $501.19 | Professional | None | $223.87 | $288.40 | $501.19 |
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 $123.03 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $123.03 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $48.98 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $186.21 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $37.15 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $24.55 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $213.80 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $173.78 | $213.80 | $213.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $407.38 Typical High $602.56 | Professional | 50 · Both sides | $331.13 | $407.38 | $602.56 |
Where Ohio sits
The same service costs 5.2 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
$269
AK $1,000UT $191
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.