How much rates vary
Facilitymedian $912 · 10th to 90th $105 to $5,623Professionalmedian $151 · 10th to 90th $105 to $263
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 $407.38 Median $1,995.26 Typical High $10,964.78 | Facility | None | $407.38 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $1,202.26 | Professional | None | $147.91 | $154.88 | $1,202.26 |
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 $104.71 Median $134.90 Typical High $218.78 | Professional | None | $104.71 | $134.90 | $218.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $147.91 Median $204.17 Typical High $316.23 | Professional | 50 · Both sides | $147.91 | $204.17 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $83.18 Median $109.65 Typical High $177.83 | Facility | None | $83.18 | $109.65 | $177.83 |
CareSource Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $162.18 Typical High $1,479.11 | Facility | None | $91.20 | $162.18 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $251.19 | Professional | None | $123.03 | $158.49 | $251.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $91.20 Median $162.18 Typical High $1,479.11 | Facility | None | $91.20 | $162.18 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $239.88 | Professional | None | $123.03 | $158.49 | $239.88 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $223.87 | Professional | None | $85.11 | $138.04 | $223.87 |
SummaCare Setting Facility Modifier None Typical Low $47.86 Median $50.12 Typical High $57.54 | Facility | None | $47.86 | $50.12 | $57.54 |
SummaCare Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $194.98 | Professional | None | $131.83 | $158.49 | $194.98 |
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 $128.82 Median $154.88 Typical High $257.04 | Professional | None | $128.82 | $154.88 | $257.04 |
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 $74.13 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $74.13 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $29.51 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $117.49 Typical High $117.49 | Professional | 54 · Surgery only | $112.20 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $22.39 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $14.79 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $104.71 | $109.65 | $109.65 |
Where Ohio sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 43rd of 51
$155
AK $603FL $132
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.