How much rates vary
Facilitymedian $708 · 10th to 90th $200 to $4,169Professionalmedian $380 · 10th to 90th $200 to $661
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 $676.08 Median $2,691.53 Typical High $10,964.78 | Facility | None | $676.08 | $2,691.53 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $1,621.81 | Professional | None | $245.47 | $371.54 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $831.76 Typical High $3,715.35 | Facility | None | $407.38 | $831.76 | $3,715.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $549.54 | Professional | None | $223.87 | $323.59 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $316.23 Median $346.74 Typical High $416.87 | Facility | None | $316.23 | $346.74 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $524.81 Typical High $1,995.26 | Facility | None | $380.19 | $524.81 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $660.69 | Professional | None | $281.84 | $416.87 | $660.69 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $524.81 Typical High $1,995.26 | Facility | None | $389.05 | $524.81 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $660.69 | Professional | None | $281.84 | $416.87 | $660.69 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $426.58 Typical High $645.65 | Professional | None | $34.67 | $426.58 | $645.65 |
SummaCare Setting Facility Modifier None Typical Low $208.93 Median $218.78 Typical High $251.19 | Facility | None | $208.93 | $218.78 | $251.19 |
SummaCare Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $562.34 | Professional | None | $275.42 | $416.87 | $562.34 |
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 $234.42 Median $380.19 Typical High $676.08 | Professional | None | $234.42 | $380.19 | $676.08 |
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 $123.03 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $123.03 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $48.98 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $186.21 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $37.15 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $24.55 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $257.04 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $173.78 | $257.04 | $257.04 |
Where Ohio sits
The same service costs 4.1 times more in New York 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
NY $3,010MD $740
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.