How much rates vary
Facilitymedian $2,455 · 10th to 90th $759 to $8,913Professionalmedian $708 · 10th to 90th $95 to $1,096
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 $2,691.53 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,691.53 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $8,912.51 | Professional | None | $870.96 | $870.96 | $8,912.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,238.72 Typical High $7,762.47 | Facility | None | $758.58 | $2,238.72 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,202.26 | Professional | None | $630.96 | $741.31 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,096.48 Typical High $1,737.80 | Professional | 50 · Both sides | $933.25 | $1,096.48 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $2,041.74 Typical High $2,630.27 | Facility | None | $1,047.13 | $2,041.74 | $2,630.27 |
CareSource Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,344.23 Typical High $3,548.13 | Facility | None | $741.31 | $2,344.23 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $1,348.96 | Professional | None | $616.60 | $912.01 | $1,348.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $2,344.23 Typical High $3,311.31 | Facility | None | $741.31 | $2,344.23 | $3,311.31 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $1,348.96 | Professional | None | $616.60 | $912.01 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $512.86 Typical High $912.01 | Professional | None | $69.18 | $512.86 | $912.01 |
SummaCare Setting Facility Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $1,348.96 | Facility | None | $1,148.15 | $1,202.26 | $1,348.96 |
SummaCare Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,096.48 | Professional | None | $758.58 | $758.58 | $1,096.48 |
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 $707.95 Median $851.14 Typical High $1,584.89 | Professional | None | $707.95 | $851.14 | $1,584.89 |
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 $436.52 Median $436.52 Typical High $1,445.44 | Professional | 52 · Reduced service | $436.52 | $436.52 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $575.44 | Professional | 53 · Discontinued | $173.78 | $173.78 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $2,137.96 | Professional | 54 · Surgery only | $645.65 | $645.65 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $426.58 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $288.40 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $1,995.26 |
Where Ohio sits
The same service costs 7.6 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
$741
AK $3,548UT $468
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.