How much rates vary
Facilitymedian $1,023 · 10th to 90th $257 to $7,762Professionalmedian $263 · 10th to 90th $54 to $427
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 $891.25 Median $7,079.46 Typical High $12,589.25 | Facility | None | $891.25 | $7,079.46 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $4,168.69 | Professional | None | $199.53 | $302.00 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $407.38 | Professional | None | $181.97 | $288.40 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $213.80 Median $239.88 Typical High $275.42 | Facility | None | $213.80 | $239.88 | $275.42 |
CareSource Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $363.08 Typical High $2,398.83 | Facility | None | $223.87 | $363.08 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $537.03 | Professional | None | $177.83 | $288.40 | $537.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $223.87 Median $363.08 Typical High $2,398.83 | Facility | None | $223.87 | $363.08 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $549.54 | Professional | None | $177.83 | $288.40 | $549.54 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $234.42 Typical High $380.19 | Professional | None | $30.90 | $234.42 | $380.19 |
SummaCare Setting Facility Modifier None Typical Low $123.03 Median $128.82 Typical High $147.91 | Facility | None | $123.03 | $128.82 | $147.91 |
SummaCare Setting Professional Modifier None Typical Low $177.83 Median $302.00 Typical High $354.81 | Professional | None | $177.83 | $302.00 | $354.81 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $5,888.44 | Facility | None | $691.83 | $1,445.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $467.74 | Professional | None | $190.55 | $281.84 | $467.74 |
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 $97.72 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $97.72 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $39.81 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $147.91 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $29.51 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.95 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $208.93 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $138.04 | $208.93 | $208.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $275.42 Median $436.52 Typical High $630.96 | Professional | 50 · Both sides | $275.42 | $436.52 | $630.96 |
Where Ohio sits
The same service costs 4.2 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· 41st of 51
$288
WY $912UT $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.