How much rates vary
Facilitymedian $776 · 10th to 90th $316 to $9,120Professionalmedian $501 · 10th to 90th $93 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 $1,348.96 Median $5,370.32 Typical High $12,589.25 | Facility | None | $1,348.96 | $5,370.32 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $1,949.84 | Professional | None | $489.78 | $512.86 | $1,949.84 |
Ambetter Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
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 $467.74 Median $602.56 Typical High $912.01 | Professional | None | $467.74 | $602.56 | $912.01 |
Aultcare Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $338.84 Typical High $588.84 | Facility | None | $263.03 | $338.84 | $588.84 |
CareSource Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $398.11 Typical High $1,479.11 | Facility | None | $288.40 | $398.11 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $1,000.00 | Professional | None | $398.11 | $524.81 | $1,000.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $288.40 Median $398.11 Typical High $1,479.11 | Facility | None | $288.40 | $398.11 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $891.25 | Professional | None | $416.87 | $524.81 | $891.25 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $323.59 Typical High $588.84 | Professional | None | $69.18 | $323.59 | $588.84 |
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 $426.58 Median $676.08 Typical High $691.83 | Professional | None | $426.58 | $676.08 | $691.83 |
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 $467.74 Median $575.44 Typical High $912.01 | Professional | None | $467.74 | $575.44 | $912.01 |
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 $245.47 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $245.47 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $97.72 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $380.19 Typical High $389.05 | Professional | 54 · Surgery only | $371.54 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $75.86 Typical High $77.62 | Professional | 55 · Aftercare only | $74.13 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $354.81 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $346.74 | $354.81 | $363.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $912.01 Typical High $1,348.96 | Professional | 50 · Both sides | $707.95 | $912.01 | $1,348.96 |
Where Ohio sits
The same service costs 6.2 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· 47th of 51
$513
AK $1,995UT $324
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.