How much rates vary
Facilitymedian $2,042 · 10th to 90th $661 to $9,120Professionalmedian $977 · 10th to 90th $141 to $1,514
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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $7,762.47 | Professional | None | $1,202.26 | $1,202.26 | $7,762.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,737.80 Typical High $7,585.78 | Facility | None | $630.96 | $1,737.80 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,584.89 | Professional | None | $831.76 | $1,000.00 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,479.11 Typical High $2,398.83 | Professional | 50 · Both sides | $1,258.93 | $1,479.11 | $2,398.83 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $1,995.26 | Facility | None | $1,445.44 | $1,548.82 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $851.14 Median $1,230.27 Typical High $1,819.70 | Professional | None | $851.14 | $1,230.27 | $1,819.70 |
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 $851.14 Median $1,230.27 Typical High $1,819.70 | Professional | None | $851.14 | $1,230.27 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $707.95 Typical High $1,258.93 | Professional | None | $102.33 | $707.95 | $1,258.93 |
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 $1,047.13 Median $1,047.13 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,047.13 | $1,513.56 |
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 $954.99 Median $1,148.15 Typical High $2,137.96 | Professional | None | $954.99 | $1,148.15 | $2,137.96 |
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 $602.56 Median $602.56 Typical High $1,905.46 | Professional | 52 · Reduced service | $602.56 | $602.56 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $758.58 | Professional | 53 · Discontinued | $239.88 | $239.88 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $2,818.38 | Professional | 54 · Surgery only | $912.01 | $912.01 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $562.34 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $380.19 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $2,630.27 |
Where Ohio sits
The same service costs 7.6 times more in Alaska than in Texas. 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
$1,000
AK $4,898TX $646
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.