How much rates vary
Facilitymedian $2,188 · 10th to 90th $661 to $8,710Professionalmedian $851 · 10th to 90th $98 to $1,288
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 $2,630.27 Median $5,754.40 Typical High $12,022.64 | Facility | None | $2,630.27 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $7,762.47 | Professional | None | $1,047.13 | $1,047.13 | $7,762.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,380.38 | Professional | None | $707.95 | $851.14 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,258.93 Typical High $2,041.74 | Professional | 50 · Both sides | $1,071.52 | $1,258.93 | $2,041.74 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $1,995.26 | Facility | None | $1,258.93 | $1,548.82 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,818.38 | Facility | None | $602.56 | $1,862.09 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $1,584.89 | Professional | None | $741.31 | $1,047.13 | $1,584.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,691.53 | Facility | None | $602.56 | $1,862.09 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $1,584.89 | Professional | None | $741.31 | $1,047.13 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $630.96 Typical High $1,071.52 | Professional | None | $69.18 | $630.96 | $1,071.52 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,071.52 | Facility | None | $891.25 | $933.25 | $1,071.52 |
SummaCare Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,318.26 | Professional | None | $912.01 | $912.01 | $1,318.26 |
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 $831.76 Median $1,000.00 Typical High $1,819.70 | Professional | None | $831.76 | $1,000.00 | $1,819.70 |
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 $524.81 Median $524.81 Typical High $1,659.59 | Professional | 52 · Reduced service | $524.81 | $524.81 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $660.69 | Professional | 53 · Discontinued | $208.93 | $208.93 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $2,511.89 | Professional | 54 · Surgery only | $794.33 | $794.33 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $501.19 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $331.13 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $2,344.23 |
Where Ohio sits
The same service costs 7.2 times more in Alaska 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
$851
AK $4,266UT $589
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.