How much rates vary
Facilitymedian $2,818 · 10th to 90th $631 to $9,333Professionalmedian $1,000 · 10th to 90th $132 to $1,660
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 $2,454.71 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,454.71 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $4,786.30 | Professional | None | $1,230.27 | $1,230.27 | $4,786.30 |
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 $1,000.00 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,258.93 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,862.09 Typical High $2,818.38 | Professional | 50 · Both sides | $1,479.11 | $1,862.09 | $2,818.38 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $4,786.30 Typical High $7,943.28 | Facility | None | $549.54 | $4,786.30 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,621.81 | $2,344.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $4,786.30 Typical High $7,585.78 | Facility | None | $549.54 | $4,786.30 | $7,585.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,621.81 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $794.33 Typical High $1,380.38 | Professional | None | $107.15 | $794.33 | $1,380.38 |
SummaCare Setting Facility Modifier None Typical Low $2,570.40 Median $2,691.53 Typical High $3,090.30 | Facility | None | $2,570.40 | $2,691.53 | $3,090.30 |
SummaCare Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,174.90 | $1,513.56 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,380.38 Typical High $2,344.23 | Professional | None | $794.33 | $1,380.38 | $2,344.23 |
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 $616.60 Median $616.60 Typical High $2,089.30 | Professional | 52 · Reduced service | $616.60 | $616.60 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $831.76 | Professional | 53 · Discontinued | $245.47 | $245.47 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $3,162.28 | Professional | 54 · Surgery only | $912.01 | $912.01 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $630.96 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $416.87 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $2,951.21 |
Where Ohio sits
The same service costs 6.1 times more in Alaska than in Texas. 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 $14,041TX $2,290
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.