How much rates vary
Facilitymedian $2,042 · 10th to 90th $794 to $10,233Professionalmedian $457 · 10th to 90th $79 to $724
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 $2,398.83 Median $9,772.37 Typical High $12,882.50 | Facility | None | $2,398.83 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $10,232.93 | Professional | None | $501.19 | $501.19 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $1,698.24 Typical High $7,762.47 | Facility | None | $776.25 | $1,698.24 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $724.44 | Professional | None | $389.05 | $457.09 | $724.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $676.08 Typical High $1,071.52 | Professional | 50 · Both sides | $575.44 | $676.08 | $1,071.52 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $1,548.82 Typical High $1,995.26 | Facility | None | $602.56 | $1,548.82 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,862.09 Typical High $3,388.44 | Facility | None | $794.33 | $1,862.09 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $831.76 | Professional | None | $346.74 | $537.03 | $831.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $851.14 Median $1,862.09 Typical High $3,388.44 | Facility | None | $851.14 | $1,862.09 | $3,388.44 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $831.76 | Professional | None | $346.74 | $537.03 | $831.76 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $309.03 Typical High $562.34 | Professional | None | $63.10 | $309.03 | $562.34 |
SummaCare Setting Facility Modifier None Typical Low $1,778.28 Median $1,862.09 Typical High $2,137.96 | Facility | None | $1,778.28 | $1,862.09 | $2,137.96 |
SummaCare Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $645.65 | Professional | None | $436.52 | $436.52 | $645.65 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $870.96 | Professional | None | $436.52 | $512.86 | $870.96 |
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 $251.19 Median $251.19 Typical High $954.99 | Professional | 52 · Reduced service | $251.19 | $251.19 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $380.19 | Professional | 53 · Discontinued | $100.00 | $100.00 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $371.54 | $371.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $281.84 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $190.55 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $1,318.26 |
Where Ohio sits
The same service costs 7.9 times more in Wyoming 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
$490
WY $2,399UT $302
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.