How much rates vary
Facilitymedian $407 · 10th to 90th $100 to $3,715Professionalmedian $195 · 10th to 90th $100 to $324
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 $154.88 Median $537.03 Typical High $10,715.19 | Facility | None | $154.88 | $537.03 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $147.91 Typical High $2,089.30 | Professional | None | $83.18 | $147.91 | $2,089.30 |
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 $141.25 Median $204.17 Typical High $316.23 | Professional | None | $141.25 | $204.17 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $102.33 Median $117.49 Typical High $134.90 | Facility | None | $102.33 | $117.49 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $117.49 Typical High $199.53 | Facility | None | $58.88 | $117.49 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $316.23 | Professional | None | $97.72 | $165.96 | $316.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $117.49 Typical High $199.53 | Facility | None | $58.88 | $117.49 | $199.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $316.23 | Professional | None | $97.72 | $165.96 | $316.23 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $316.23 | Professional | None | $169.82 | $229.09 | $316.23 |
SummaCare Setting Facility Modifier None Typical Low $114.82 Median $120.23 Typical High $134.90 | Facility | None | $114.82 | $120.23 | $134.90 |
SummaCare Setting Professional Modifier None Typical Low $93.33 Median $169.82 Typical High $245.47 | Professional | None | $93.33 | $169.82 | $245.47 |
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 $91.20 Median $165.96 Typical High $288.40 | Professional | None | $91.20 | $165.96 | $288.40 |
5 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 $41.69 Median $74.13 Typical High $81.28 | Professional | 52 · Reduced service | $41.69 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $29.51 Typical High $32.36 | Professional | 53 · Discontinued | $16.60 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $112.20 Typical High $123.03 | Professional | 54 · Surgery only | $63.10 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $22.39 Typical High $24.55 | Professional | 55 · Aftercare only | $12.59 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $14.79 Typical High $16.22 | Professional | 56 · Pre-op care only | $8.32 | $14.79 | $16.22 |
Where Ohio sits
The same service costs 11.6 times more in Hawaii than in Maryland. 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.
Physician feeFacility fee
HI $3,027MD $261
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.