How much rates vary
Facilitymedian $1,202 · 10th to 90th $123 to $12,023Professionalmedian $513 · 10th to 90th $398 to $871
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 $870.96 Median $2,951.21 Typical High $12,022.64 | Facility | None | $870.96 | $2,951.21 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $2,089.30 | Professional | None | $478.63 | $478.63 | $2,089.30 |
Ambetter Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $6,760.83 Typical High $18,620.87 | Facility | None | $1,096.48 | $6,760.83 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $776.25 | Professional | None | $398.11 | $501.19 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $79.43 Typical High $123.03 | Professional | 80 · Assistant surgeon | $64.57 | $79.43 | $123.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $70.79 Typical High $107.15 | Professional | AS · PA/NP assist | $56.23 | $70.79 | $107.15 |
Aultcare Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $776.25 | Professional | None | $512.86 | $512.86 | $776.25 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $691.83 Typical High $8,912.51 | Facility | None | $512.86 | $691.83 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $933.25 | Professional | None | $489.78 | $645.65 | $933.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $691.83 Typical High $8,912.51 | Facility | None | $512.86 | $691.83 | $8,912.51 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $891.25 | Professional | None | $501.19 | $645.65 | $891.25 |
Molina Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $724.44 | Professional | None | $389.05 | $501.19 | $724.44 |
SummaCare Setting Professional Modifier None Typical Low $426.58 Median $446.68 Typical High $707.95 | Professional | None | $426.58 | $446.68 | $707.95 |
United Setting Facility Modifier None Typical Low $97.72 Median $263.03 Typical High $4,786.30 | Facility | None | $97.72 | $263.03 | $4,786.30 |
United Setting Professional Modifier None Typical Low $309.03 Median $549.54 Typical High $933.25 | Professional | None | $309.03 | $549.54 | $933.25 |
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 $234.42 Median $234.42 Typical High $616.60 | Professional | 52 · Reduced service | $234.42 | $234.42 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $245.47 | Professional | 53 · Discontinued | $95.50 | $95.50 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $977.24 | Professional | 54 · Surgery only | $354.81 | $354.81 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $186.21 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $123.03 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $123.03 |
Where Ohio sits
The same service costs 22.9 times more in Alabama 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
AL $15,380DE $671
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.