How much rates vary
Facilitymedian $617 · 10th to 90th $79 to $5,012Professionalmedian $95 · 10th to 90th $74 to $158
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 $95.50 Median $10,232.93 Typical High $13,803.84 | Facility | None | $95.50 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $186.21 | Professional | None | $79.43 | $95.50 | $186.21 |
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 $72.44 Median $104.71 Typical High $151.36 | Professional | None | $72.44 | $104.71 | $151.36 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $109.65 Median $154.88 Typical High $223.87 | Professional | 50 · Both sides | $109.65 | $154.88 | $223.87 |
Aultcare Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $537.03 Typical High $812.83 | Facility | None | $93.33 | $537.03 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $707.95 | Facility | None | $50.12 | $66.07 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $91.20 Typical High $199.53 | Professional | None | $70.79 | $91.20 | $199.53 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $707.95 | Facility | None | $50.12 | $66.07 | $707.95 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $74.13 Median $79.43 Typical High $154.88 | Professional | None | $74.13 | $79.43 | $154.88 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $151.36 | Professional | None | $79.43 | $102.33 | $151.36 |
SummaCare Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $109.65 | Professional | None | $70.79 | $93.33 | $109.65 |
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 $75.86 Median $97.72 Typical High $162.18 | Professional | None | $75.86 | $97.72 | $162.18 |
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 $38.90 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $38.90 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $15.85 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $70.79 Typical High $70.79 | Professional | 54 · Surgery only | $58.88 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $11.75 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.94 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $66.07 Typical High $66.07 | Professional | 78 · Unplanned return to OR | $54.95 | $66.07 | $66.07 |
Where Ohio sits
The same service costs 4.2 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· 43rd of 51
$100
AK $324FL $77.62
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.