How much rates vary
Facilitymedian $6,607 · 10th to 90th $2,512 to $9,772Professionalmedian $1,318 · 10th to 90th $468 to $3,311
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 $2,511.89 Median $6,760.83 Typical High $8,128.31 | Facility | None | $2,511.89 | $6,760.83 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $8,511.38 | Professional | None | $2,511.89 | $2,511.89 | $8,511.38 |
Ambetter Setting Professional Modifier None Typical Low $1,949.84 Median $3,388.44 Typical High $3,388.44 | Professional | None | $1,949.84 | $3,388.44 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $831.76 | Professional | None | $467.74 | $512.86 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,570.40 | Professional | None | $2,290.87 | $2,290.87 | $2,570.40 |
SummaCare Setting Professional Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $3,890.45 | Professional | None | $2,454.71 | $2,570.40 | $3,890.45 |
United Setting Facility Modifier None Typical Low $3,548.13 Median $6,606.93 Typical High $9,772.37 | Facility | None | $3,548.13 | $6,606.93 | $9,772.37 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $2,398.83 Typical High $4,786.30 | Professional | None | $1,348.96 | $2,398.83 | $4,786.30 |
10 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 Facility Modifier 52 · Reduced service Typical Low $1,258.93 Median $3,388.44 Typical High $4,073.80 | Facility | 52 · Reduced service | $1,258.93 | $3,388.44 | $4,073.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $501.19 Median $1,380.38 Typical High $1,621.81 | Facility | 53 · Discontinued | $501.19 | $1,380.38 | $1,621.81 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $1,905.46 Median $5,128.61 Typical High $6,025.60 | Facility | 54 · Surgery only | $1,905.46 | $5,128.61 | $6,025.60 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $380.19 Median $1,023.29 Typical High $1,230.27 | Facility | 55 · Aftercare only | $380.19 | $1,023.29 | $1,230.27 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $251.19 Median $676.08 Typical High $812.83 | Facility | 56 · Pre-op care only | $251.19 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,258.93 Median $1,258.93 Typical High $4,265.80 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $4,265.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $501.19 Typical High $1,698.24 | Professional | 53 · Discontinued | $501.19 | $501.19 | $1,698.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $6,309.57 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $6,309.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $1,288.25 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $1,288.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $251.19 Typical High $851.14 | Professional | 56 · Pre-op care only | $251.19 | $251.19 | $851.14 |
Where Ohio sits
The same service costs 9.3 times more in Alaska than in Indiana. 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
$1,698
AK $6,457IN $692
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.