How much rates vary
Facilitymedian $1,549 · 10th to 90th $631 to $7,244Professionalmedian $692 · 10th to 90th $162 to $1,202
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 $1,071.52 Median $2,454.71 Typical High $10,964.78 | Facility | None | $1,071.52 | $2,454.71 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $3,801.89 | Professional | None | $588.84 | $724.44 | $3,801.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,230.27 Typical High $4,786.30 | Facility | None | $575.44 | $1,230.27 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $1,071.52 | Professional | None | $489.78 | $676.08 | $1,071.52 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $954.99 Typical High $1,230.27 | Facility | None | $831.76 | $954.99 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $2,398.83 | Facility | None | $602.56 | $1,202.26 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,318.26 | Professional | None | $562.34 | $707.95 | $1,318.26 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $2,398.83 | Facility | None | $602.56 | $1,202.26 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,318.26 | Professional | None | $562.34 | $707.95 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $630.96 Typical High $1,096.48 | Professional | None | $114.82 | $630.96 | $1,096.48 |
SummaCare Setting Facility Modifier None Typical Low $575.44 Median $616.60 Typical High $691.83 | Facility | None | $575.44 | $616.60 | $691.83 |
SummaCare Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,023.29 | Professional | None | $616.60 | $870.96 | $1,023.29 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $5,888.44 | Facility | None | $691.83 | $1,445.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,380.38 | Professional | None | $549.54 | $776.25 | $1,380.38 |
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 $288.40 Median $363.08 Typical High $407.38 | Professional | 52 · Reduced service | $288.40 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $144.54 Typical High $162.18 | Professional | 53 · Discontinued | $117.49 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $537.03 Typical High $602.56 | Professional | 54 · Surgery only | $436.52 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $107.15 Typical High $120.23 | Professional | 55 · Aftercare only | $87.10 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $72.44 Typical High $81.28 | Professional | 56 · Pre-op care only | $58.88 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $501.19 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $407.38 | $501.19 | $562.34 |
Where Ohio sits
The same service costs 3.1 times more in Alaska 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
AK $5,990MD $1,938
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.