How much rates vary
Facilitymedian $1,905 · 10th to 90th $537 to $5,248Professionalmedian $724 · 10th to 90th $112 to $1,148
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 $1,258.93 Median $3,019.95 Typical High $10,964.78 | Facility | None | $1,258.93 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $3,548.13 | Professional | None | $691.83 | $851.14 | $3,548.13 |
Ambetter Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $933.25 | Professional | None | $724.44 | $933.25 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,148.15 Typical High $4,466.84 | Facility | None | $524.81 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,071.52 | Professional | None | $616.60 | $758.58 | $1,071.52 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $977.24 Typical High $1,230.27 | Facility | None | $954.99 | $977.24 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,995.26 Typical High $2,951.21 | Facility | None | $489.78 | $1,995.26 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,380.38 | Professional | None | $758.58 | $831.76 | $1,380.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,995.26 Typical High $3,090.30 | Facility | None | $512.86 | $1,995.26 | $3,090.30 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,380.38 | Professional | None | $758.58 | $831.76 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $549.54 Typical High $933.25 | Professional | None | $77.62 | $549.54 | $933.25 |
SummaCare Setting Facility Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,398.83 | Facility | None | $1,995.26 | $2,089.30 | $2,398.83 |
SummaCare Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,148.15 | Professional | None | $758.58 | $758.58 | $1,148.15 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,786.30 | Facility | None | $501.19 | $977.24 | $4,786.30 |
United Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,513.56 | Professional | None | $616.60 | $831.76 | $1,513.56 |
7 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 $346.74 Median $346.74 Typical High $933.25 | Professional | 52 · Reduced service | $346.74 | $346.74 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $371.54 | Professional | 53 · Discontinued | $138.04 | $138.04 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $1,380.38 | Professional | 54 · Surgery only | $512.86 | $512.86 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $275.42 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $186.21 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $1,288.25 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $891.25 Median $1,000.00 Typical High $1,584.89 | Professional | 58 · Staged procedure | $891.25 | $1,000.00 | $1,584.89 |
Where Ohio sits
The same service costs 3.5 times more in Alaska than in Georgia. 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
AK $7,038GA $2,000
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.