How much rates vary
Facilitymedian $1,023 · 10th to 90th $447 to $4,898Professionalmedian $398 · 10th to 90th $51 to $631
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 $707.95 Median $4,365.16 Typical High $12,589.25 | Facility | None | $707.95 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $1,258.93 | Professional | None | $398.11 | $426.58 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,148.15 Typical High $4,466.84 | Facility | None | $524.81 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $588.84 | Professional | None | $288.40 | $354.81 | $588.84 |
CareSource Setting Facility Modifier None Typical Low $501.19 Median $812.83 Typical High $1,047.13 | Facility | None | $501.19 | $812.83 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $933.25 Typical High $1,995.26 | Facility | None | $489.78 | $933.25 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $741.31 | Professional | None | $398.11 | $501.19 | $741.31 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $933.25 Typical High $1,995.26 | Facility | None | $512.86 | $933.25 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $724.44 | Professional | None | $398.11 | $501.19 | $724.44 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $331.13 Typical High $588.84 | Professional | None | $33.88 | $331.13 | $588.84 |
SummaCare Setting Facility Modifier None Typical Low $446.68 Median $467.74 Typical High $537.03 | Facility | None | $446.68 | $467.74 | $537.03 |
SummaCare Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $575.44 | Professional | None | $416.87 | $489.78 | $575.44 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,388.44 | Facility | None | $363.08 | $691.83 | $3,388.44 |
United Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $724.44 | Professional | None | $269.15 | $416.87 | $724.44 |
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 $199.53 Median $213.80 Typical High $229.09 | Professional | 52 · Reduced service | $199.53 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $85.11 Typical High $91.20 | Professional | 53 · Discontinued | $79.43 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $323.59 Typical High $346.74 | Professional | 54 · Surgery only | $295.12 | $323.59 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $64.57 Typical High $69.18 | Professional | 55 · Aftercare only | $58.88 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $42.66 Typical High $45.71 | Professional | 56 · Pre-op care only | $39.81 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $302.00 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $275.42 | $302.00 | $323.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $537.03 Typical High $891.25 | Professional | 50 · Both sides | $426.58 | $537.03 | $891.25 |
Where Ohio sits
The same service costs 4.5 times more in Vermont than in Florida. 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
VT $4,521FL $1,007
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.