How much rates vary
Facilitymedian $1,023 · 10th to 90th $269 to $5,888Professionalmedian $316 · 10th to 90th $54 to $501
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 $426.58 Median $3,548.13 Typical High $12,022.64 | Facility | None | $426.58 | $3,548.13 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $2,951.21 | Professional | None | $234.42 | $363.08 | $2,951.21 |
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 $194.98 Median $316.23 Typical High $457.09 | Professional | None | $194.98 | $316.23 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $281.84 Typical High $281.84 | Facility | None | $218.78 | $281.84 | $281.84 |
CareSource Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $416.87 Typical High $3,388.44 | Facility | None | $239.88 | $416.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $338.84 Typical High $549.54 | Professional | None | $199.53 | $338.84 | $549.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $239.88 Median $416.87 Typical High $3,388.44 | Facility | None | $239.88 | $416.87 | $3,388.44 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $524.81 | Professional | None | $199.53 | $316.23 | $524.81 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $309.03 Typical High $489.78 | Professional | None | $30.90 | $309.03 | $489.78 |
SummaCare Setting Facility Modifier None Typical Low $125.89 Median $131.83 Typical High $151.36 | Facility | None | $125.89 | $131.83 | $151.36 |
SummaCare Setting Professional Modifier None Typical Low $199.53 Median $371.54 Typical High $436.52 | Professional | None | $199.53 | $371.54 | $436.52 |
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 $218.78 Median $331.13 Typical High $549.54 | Professional | None | $218.78 | $331.13 | $549.54 |
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 $117.49 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $117.49 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $46.77 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $177.83 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $35.48 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $23.44 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $257.04 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $165.96 | $257.04 | $257.04 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $295.12 Median $478.63 Typical High $691.83 | Professional | 50 · Both sides | $295.12 | $478.63 | $691.83 |
Where Ohio sits
The same service costs 3.9 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· 41st of 51
$331
WY $1,096UT $282
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.