How much rates vary
Facilitymedian $2,188 · 10th to 90th $661 to $9,120Professionalmedian $1,096 · 10th to 90th $891 to $2,089
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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $9,120.11 | Professional | None | $1,096.48 | $1,096.48 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,584.89 | Professional | None | $891.25 | $1,096.48 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,621.81 Typical High $2,454.71 | Professional | 50 · Both sides | $1,348.96 | $1,621.81 | $2,454.71 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $2,454.71 | Facility | None | $1,548.82 | $1,905.46 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,041.74 Typical High $3,090.30 | Facility | None | $562.34 | $2,041.74 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,258.93 | $2,089.30 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $2,951.21 | Facility | None | $602.56 | $2,041.74 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,258.93 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Facility Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,202.26 | Facility | None | $1,000.00 | $1,047.13 | $1,202.26 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $2,398.83 | Professional | None | $912.01 | $1,288.25 | $2,398.83 |
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 $549.54 Median $549.54 Typical High $3,548.13 | Professional | 52 · Reduced service | $549.54 | $549.54 | $3,548.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $1,412.54 | Professional | 53 · Discontinued | $218.78 | $218.78 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $5,370.32 | Professional | 54 · Surgery only | $812.83 | $812.83 | $5,370.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $1,071.52 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $707.95 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $707.95 |
Where Ohio sits
The same service costs 4.8 times more in Alaska than in New York. 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.
Ohio· 50th of 51
$1,096
AK $5,129NY $1,072
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.