How much rates vary
Facilitymedian $447 · 10th to 90th $87 to $3,715Professionalmedian $129 · 10th to 90th $83 to $240
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 $316.23 Median $1,995.26 Typical High $10,964.78 | Facility | None | $316.23 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $478.63 | Professional | None | $114.82 | $144.54 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $67.61 Typical High $131.83 | Professional | None | $66.07 | $67.61 | $131.83 |
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 $91.20 Median $125.89 Typical High $190.55 | Professional | None | $91.20 | $125.89 | $190.55 |
Aultcare Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $87.10 Median $114.82 Typical High $138.04 | Facility | None | $87.10 | $114.82 | $138.04 |
CareSource Setting Professional Modifier None Typical Low $128.82 Median $131.83 Typical High $177.83 | Professional | None | $128.82 | $131.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $102.33 Typical High $186.21 | Facility | None | $58.88 | $102.33 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $245.47 | Professional | None | $104.71 | $147.91 | $245.47 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $102.33 Typical High $204.17 | Facility | None | $58.88 | $102.33 | $204.17 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $75.86 Median $131.83 Typical High $251.19 | Professional | None | $75.86 | $131.83 | $251.19 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $181.97 | Professional | None | $81.28 | $120.23 | $181.97 |
SummaCare Setting Facility Modifier None Typical Low $48.98 Median $51.29 Typical High $58.88 | Facility | None | $48.98 | $51.29 | $58.88 |
SummaCare Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $186.21 | Professional | None | $104.71 | $141.25 | $186.21 |
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 $104.71 Median $134.90 Typical High $234.42 | Professional | None | $104.71 | $134.90 | $234.42 |
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 $57.54 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $57.54 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $22.91 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $107.15 Typical High $107.15 | Professional | 54 · Surgery only | $87.10 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $17.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.48 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $100.00 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $81.28 | $100.00 | $100.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $134.90 Median $190.55 Typical High $288.40 | Professional | 50 · Both sides | $134.90 | $190.55 | $288.40 |
Where Ohio sits
The same service costs 4.1 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· 44th of 51
$135
AK $468FL $115
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.