How much rates vary
Facilitymedian $1,862 · 10th to 90th $661 to $8,511Professionalmedian $417 · 10th to 90th $79 to $741
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 $1,174.90 Median $5,754.40 Typical High $12,022.64 | Facility | None | $1,174.90 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $3,715.35 | Professional | None | $426.58 | $426.58 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $7,585.78 | Facility | None | $630.96 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $1,047.13 | Professional | None | $512.86 | $724.44 | $1,047.13 |
Aultcare Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $1,513.56 Typical High $1,995.26 | Facility | None | $549.54 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $851.14 | Professional | None | $436.52 | $549.54 | $851.14 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $891.25 | Professional | None | $436.52 | $549.54 | $891.25 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $323.59 Typical High $512.86 | Professional | None | $67.61 | $323.59 | $512.86 |
SummaCare Setting Facility Modifier None Typical Low $851.14 Median $891.25 Typical High $1,000.00 | Facility | None | $851.14 | $891.25 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $549.54 | Professional | None | $380.19 | $416.87 | $549.54 |
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 $269.15 Median $549.54 Typical High $933.25 | Professional | None | $269.15 | $549.54 | $933.25 |
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 $213.80 Median $213.80 Typical High $1,148.15 | Professional | 52 · Reduced service | $213.80 | $213.80 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $467.74 | Professional | 53 · Discontinued | $85.11 | $85.11 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $1,737.80 | Professional | 54 · Surgery only | $323.59 | $323.59 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $346.74 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $229.09 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $1,621.81 |
Where Ohio sits
The same service costs 5.0 times more in Wisconsin than in Montana. 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
WI $7,200MT $1,432
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.