How much rates vary
Facilitymedian $1,479 · 10th to 90th $603 to $7,413Professionalmedian $479 · 10th to 90th $91 to $794
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 $1,230.27 Median $3,801.89 Typical High $10,964.78 | Facility | None | $1,230.27 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $1,995.26 | Professional | None | $446.68 | $575.44 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,148.15 Typical High $4,786.30 | Facility | None | $562.34 | $1,148.15 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $758.58 | Professional | None | $398.11 | $501.19 | $758.58 |
Aultcare Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $537.03 Median $1,000.00 Typical High $1,288.25 | Facility | None | $537.03 | $1,000.00 | $1,288.25 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,148.15 Typical High $2,398.83 | Facility | None | $562.34 | $1,148.15 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $870.96 | Professional | None | $371.54 | $575.44 | $870.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,148.15 Typical High $2,398.83 | Facility | None | $602.56 | $1,148.15 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $371.54 Median $562.34 Typical High $870.96 | Professional | None | $371.54 | $562.34 | $870.96 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $380.19 Typical High $691.83 | Professional | None | $69.18 | $380.19 | $691.83 |
SummaCare Setting Facility Modifier None Typical Low $562.34 Median $588.84 Typical High $660.69 | Facility | None | $562.34 | $588.84 | $660.69 |
SummaCare Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $691.83 | Professional | None | $389.05 | $588.84 | $691.83 |
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 $407.38 Median $524.81 Typical High $912.01 | Professional | None | $407.38 | $524.81 | $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 $223.87 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $223.87 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $89.13 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $338.84 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $67.61 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $44.67 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $316.23 | $407.38 | $407.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $741.31 Typical High $1,122.02 | Professional | 50 · Both sides | $588.84 | $741.31 | $1,122.02 |
Where Ohio sits
The same service costs 4.0 times more in Oklahoma than in West Virginia. 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.
Physician feeFacility fee
OK $5,056WV $1,262
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.