How much rates vary
Facilitymedian $741 · 10th to 90th $204 to $9,120Professionalmedian $302 · 10th to 90th $50 to $813
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 $741.31 Median $5,370.32 Typical High $12,589.25 | Facility | None | $741.31 | $5,370.32 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $295.12 Typical High $2,290.87 | Professional | None | $269.15 | $295.12 | $2,290.87 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $831.76 Typical High $3,311.31 | Facility | None | $371.54 | $831.76 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $616.60 Typical High $831.76 | Professional | None | $295.12 | $616.60 | $831.76 |
Aultcare Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $162.18 Median $208.93 Typical High $323.59 | Facility | None | $162.18 | $208.93 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $316.23 Typical High $1,479.11 | Facility | None | $173.78 | $316.23 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $933.25 | Professional | None | $229.09 | $302.00 | $933.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $173.78 Median $309.03 Typical High $1,479.11 | Facility | None | $173.78 | $309.03 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $1,071.52 | Professional | None | $239.88 | $309.03 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $223.87 Typical High $354.81 | Professional | None | $30.20 | $223.87 | $354.81 |
SummaCare Setting Facility Modifier None Typical Low $93.33 Median $97.72 Typical High $109.65 | Facility | None | $93.33 | $97.72 | $109.65 |
SummaCare Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $354.81 | Professional | None | $239.88 | $295.12 | $354.81 |
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 $269.15 Median $489.78 Typical High $758.58 | Professional | None | $269.15 | $489.78 | $758.58 |
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 $134.90 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $134.90 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $54.95 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $204.17 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $40.74 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $26.92 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $204.17 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $190.55 | $204.17 | $204.17 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $912.01 Typical High $1,288.25 | Professional | 50 · Both sides | $446.68 | $912.01 | $1,288.25 |
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· 46th of 51
$316
AK $1,096UT $219
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.