How much rates vary
Facilitymedian $1,288 · 10th to 90th $575 to $7,244Professionalmedian $776 · 10th to 90th $162 to $1,259
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 $954.99 Median $7,079.46 Typical High $12,589.25 | Facility | None | $954.99 | $7,079.46 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $5,754.40 | Professional | None | $630.96 | $776.25 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,174.90 Typical High $4,786.30 | Facility | None | $562.34 | $1,174.90 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,202.26 | Professional | None | $549.54 | $776.25 | $1,202.26 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $954.99 Typical High $1,230.27 | Facility | None | $891.25 | $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 $616.60 Median $776.25 Typical High $1,445.44 | Professional | None | $616.60 | $776.25 | $1,445.44 |
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 $616.60 Median $776.25 Typical High $1,445.44 | Professional | None | $616.60 | $776.25 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $707.95 Typical High $1,202.26 | Professional | None | $114.82 | $707.95 | $1,202.26 |
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 $676.08 Median $977.24 Typical High $1,148.15 | Professional | None | $676.08 | $977.24 | $1,148.15 |
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 $602.56 Median $851.14 Typical High $1,513.56 | Professional | None | $602.56 | $851.14 | $1,513.56 |
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 $316.23 Median $389.05 Typical High $446.68 | Professional | 52 · Reduced service | $316.23 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $154.88 Typical High $177.83 | Professional | 53 · Discontinued | $125.89 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $588.84 Typical High $660.69 | Professional | 54 · Surgery only | $478.63 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $117.49 Typical High $131.83 | Professional | 55 · Aftercare only | $95.50 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $77.62 Typical High $89.13 | Professional | 56 · Pre-op care only | $63.10 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $549.54 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $446.68 | $549.54 | $616.60 |
Where Ohio sits
The same service costs 3.7 times more in Alaska than in Delaware. 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 $6,113DE $1,645
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.