How much rates vary
Facilitymedian $603 · 10th to 90th $129 to $3,548Professionalmedian $316 · 10th to 90th $52 to $537
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 $436.52 Median $1,047.13 Typical High $10,715.19 | Facility | None | $436.52 | $1,047.13 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $1,122.02 | Professional | None | $295.12 | $331.13 | $1,122.02 |
Ambetter Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $501.19 | Professional | None | $371.54 | $501.19 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $831.76 Typical High $3,311.31 | Facility | None | $371.54 | $831.76 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $457.09 | Professional | None | $186.21 | $234.42 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $380.19 | Facility | None | $125.89 | $162.18 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $245.47 Typical High $1,479.11 | Facility | None | $131.83 | $245.47 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $575.44 | Professional | None | $288.40 | $398.11 | $575.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $131.83 Median $288.40 Typical High $1,348.96 | Facility | None | $131.83 | $288.40 | $1,348.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $562.34 | Professional | None | $288.40 | $398.11 | $562.34 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $295.12 Typical High $524.81 | Professional | None | $33.88 | $295.12 | $524.81 |
SummaCare Setting Facility Modifier None Typical Low $69.18 Median $72.44 Typical High $83.18 | Facility | None | $69.18 | $72.44 | $83.18 |
SummaCare Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $501.19 | Professional | None | $363.08 | $426.58 | $501.19 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $549.54 | Professional | None | $199.53 | $295.12 | $549.54 |
7 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 $147.91 Median $165.96 Typical High $173.78 | Professional | 52 · Reduced service | $147.91 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $66.07 Typical High $69.18 | Professional | 53 · Discontinued | $60.26 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $245.47 Typical High $263.03 | Professional | 54 · Surgery only | $223.87 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $48.98 Typical High $52.48 | Professional | 55 · Aftercare only | $44.67 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $33.11 Typical High $34.67 | Professional | 56 · Pre-op care only | $29.51 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $229.09 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $208.93 | $229.09 | $245.47 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $281.84 Median $354.81 Typical High $676.08 | Professional | 50 · Both sides | $281.84 | $354.81 | $676.08 |
Where Ohio sits
The same service costs 6.3 times more in Connecticut than in Maryland. 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
CT $3,109MD $497
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.