How much rates vary
Facilitymedian $1,202 · 10th to 90th $513 to $8,128Professionalmedian $490 · 10th to 90th $83 to $776
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 $8,511.38 Typical High $13,803.84 | Facility | None | $2,344.23 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $8,912.51 | Professional | None | $616.60 | $616.60 | $8,912.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $1,174.90 Typical High $4,786.30 | Facility | None | $616.60 | $1,174.90 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $831.76 | Professional | None | $407.38 | $512.86 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $776.25 Typical High $1,230.27 | Professional | 50 · Both sides | $602.56 | $776.25 | $1,230.27 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,288.25 | Facility | None | $741.31 | $1,000.00 | $1,288.25 |
CareSource Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,174.90 Typical High $2,951.21 | Facility | None | $676.08 | $1,174.90 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $977.24 | Professional | None | $436.52 | $660.69 | $977.24 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $691.83 Median $1,174.90 Typical High $2,951.21 | Facility | None | $691.83 | $1,174.90 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $977.24 | Professional | None | $436.52 | $660.69 | $977.24 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $354.81 Typical High $630.96 | Professional | None | $69.18 | $354.81 | $630.96 |
SummaCare Setting Facility Modifier None Typical Low $562.34 Median $588.84 Typical High $660.69 | Facility | None | $562.34 | $588.84 | $660.69 |
SummaCare Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $812.83 | Professional | None | $537.03 | $537.03 | $812.83 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,388.44 | Facility | None | $363.08 | $691.83 | $3,388.44 |
United Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $1,122.02 | Professional | None | $467.74 | $616.60 | $1,122.02 |
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 $309.03 Median $309.03 Typical High $1,096.48 | Professional | 52 · Reduced service | $309.03 | $309.03 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $436.52 | Professional | 53 · Discontinued | $123.03 | $123.03 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $1,659.59 | Professional | 54 · Surgery only | $467.74 | $467.74 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $331.13 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $218.78 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $1,548.82 |
Where Ohio sits
The same service costs 7.6 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
$513
AK $2,512UT $331
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.