How much rates vary
Facilitymedian $525 · 10th to 90th $98 to $3,981Professionalmedian $372 · 10th to 90th $56 to $631
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 $954.99 Median $3,235.94 Typical High $12,589.25 | Facility | None | $954.99 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $1,445.44 | Professional | None | $251.19 | $426.58 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $371.54 Typical High $524.81 | Professional | None | $208.93 | $371.54 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $154.88 Median $199.53 Typical High $302.00 | Facility | None | $154.88 | $199.53 | $302.00 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $190.55 Typical High $537.03 | Facility | None | $58.88 | $190.55 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $363.08 Typical High $724.44 | Professional | None | $213.80 | $363.08 | $724.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $186.21 Typical High $537.03 | Facility | None | $58.88 | $186.21 | $537.03 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $758.58 | Professional | None | $213.80 | $354.81 | $758.58 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $346.74 Typical High $549.54 | Professional | None | $30.90 | $346.74 | $549.54 |
SummaCare Setting Facility Modifier None Typical Low $89.13 Median $93.33 Typical High $107.15 | Facility | None | $89.13 | $93.33 | $107.15 |
SummaCare Setting Professional Modifier None Typical Low $213.80 Median $426.58 Typical High $707.95 | Professional | None | $213.80 | $426.58 | $707.95 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $645.65 | Professional | None | $229.09 | $389.05 | $645.65 |
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 $125.89 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $125.89 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $50.12 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $190.55 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $38.02 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $25.12 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $177.83 | $295.12 | $295.12 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $562.34 Typical High $794.33 | Professional | 50 · Both sides | $316.23 | $562.34 | $794.33 |
Where Ohio sits
The same service costs 3.4 times more in Alaska than in Maryland. 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
$372
AK $1,023MD $302
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.