How much rates vary
Facilitymedian $1,259 · 10th to 90th $513 to $5,248Professionalmedian $295 · 10th to 90th $195 to $562
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 $1,000.00 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,000.00 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $2,570.40 | Professional | None | $194.98 | $295.12 | $2,570.40 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $4,570.88 | Facility | None | $524.81 | $1,122.02 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $436.52 | Professional | None | $190.55 | $275.42 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $275.42 Median $954.99 Typical High $1,230.27 | Facility | None | $275.42 | $954.99 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,202.26 Typical High $1,819.70 | Facility | None | $512.86 | $1,202.26 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $537.03 | Professional | None | $194.98 | $288.40 | $537.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $1,202.26 Typical High $1,698.24 | Facility | None | $501.19 | $1,202.26 | $1,698.24 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $524.81 | Professional | None | $194.98 | $288.40 | $524.81 |
Molina Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $575.44 | Professional | None | $316.23 | $416.87 | $575.44 |
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 $204.17 Median $309.03 Typical High $426.58 | Professional | None | $204.17 | $309.03 | $426.58 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $549.54 | Professional | None | $199.53 | $309.03 | $549.54 |
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 $97.72 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $97.72 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $38.90 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $144.54 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $28.84 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $19.50 | $29.51 | $29.51 |
Where Ohio sits
The same service costs 6.1 times more in Michigan than in Montana. 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
MI $4,783MT $790
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.