How much rates vary
Facilitymedian $417 · 10th to 90th $81 to $3,715Professionalmedian $123 · 10th to 90th $91 to $224
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 $309.03 Median $1,995.26 Typical High $10,964.78 | Facility | None | $309.03 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $416.87 | Professional | None | $114.82 | $131.83 | $416.87 |
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 $77.62 Median $107.15 Typical High $177.83 | Professional | None | $77.62 | $107.15 | $177.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $158.49 Typical High $269.15 | Professional | 50 · Both sides | $117.49 | $158.49 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $79.43 Median $104.71 Typical High $141.25 | Facility | None | $79.43 | $104.71 | $141.25 |
CareSource Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $95.50 Typical High $173.78 | Facility | None | $58.88 | $95.50 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $208.93 | Professional | None | $102.33 | $131.83 | $208.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $95.50 Typical High $190.55 | Facility | None | $58.88 | $95.50 | $190.55 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $295.12 | Professional | None | $107.15 | $134.90 | $295.12 |
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 $45.71 Median $47.86 Typical High $54.95 | Facility | None | $45.71 | $47.86 | $54.95 |
SummaCare Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $154.88 | Professional | None | $104.71 | $117.49 | $154.88 |
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 $95.50 Median $120.23 Typical High $208.93 | Professional | None | $95.50 | $120.23 | $208.93 |
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 $57.54 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $57.54 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $23.44 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | 54 · Surgery only | $87.10 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $17.38 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $11.48 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $91.20 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $81.28 | $91.20 | $91.20 |
Where Ohio sits
The same service costs 4.4 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· 45th of 51
$126
AK $468FL $107
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.