How much rates vary
Facilitymedian $646 · 10th to 90th $129 to $3,715Professionalmedian $447 · 10th to 90th $85 to $708
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 $1,230.27 Median $1,995.26 Typical High $10,964.78 | Facility | None | $1,230.27 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $1,621.81 | Professional | None | $446.68 | $489.78 | $1,621.81 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
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 $331.13 Median $407.38 Typical High $660.69 | Professional | None | $331.13 | $407.38 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $575.44 | Facility | None | $125.89 | $162.18 | $575.44 |
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 $457.09 Median $562.34 Typical High $831.76 | Professional | None | $457.09 | $562.34 | $831.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $131.83 Median $234.42 Typical High $1,479.11 | Facility | None | $131.83 | $234.42 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $812.83 | Professional | None | $457.09 | $562.34 | $812.83 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $380.19 Typical High $645.65 | Professional | None | $69.18 | $380.19 | $645.65 |
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 $457.09 Median $549.54 Typical High $645.65 | Professional | None | $457.09 | $549.54 | $645.65 |
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 $302.00 Median $478.63 Typical High $831.76 | Professional | None | $302.00 | $478.63 | $831.76 |
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 $223.87 Median $245.47 Typical High $263.03 | Professional | 52 · Reduced service | $223.87 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $97.72 Typical High $104.71 | Professional | 53 · Discontinued | $91.20 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $363.08 Typical High $389.05 | Professional | 54 · Surgery only | $338.84 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $72.44 Typical High $79.43 | Professional | 55 · Aftercare only | $67.61 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $48.98 Typical High $52.48 | Professional | 56 · Pre-op care only | $44.67 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $338.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $316.23 | $338.84 | $363.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $616.60 Typical High $1,000.00 | Professional | 50 · Both sides | $489.78 | $616.60 | $1,000.00 |
Where Ohio sits
The same service costs 4.7 times more in New York 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
NY $3,038FL $649
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.