How much rates vary
Facilitymedian $1,995 · 10th to 90th $661 to $9,120Professionalmedian $646 · 10th to 90th $89 to $1,072
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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $5,754.40 | Professional | None | $758.58 | $758.58 | $5,754.40 |
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 $602.56 Median $741.31 Typical High $1,258.93 | Professional | None | $602.56 | $741.31 | $1,258.93 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $1,513.56 Typical High $1,995.26 | Facility | None | $954.99 | $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 $758.58 Median $954.99 Typical High $1,412.54 | Professional | None | $758.58 | $954.99 | $1,412.54 |
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 $758.58 Median $954.99 Typical High $1,412.54 | Professional | None | $758.58 | $954.99 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $537.03 Typical High $954.99 | Professional | None | $70.79 | $537.03 | $954.99 |
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 $707.95 Median $776.25 Typical High $1,023.29 | Professional | None | $707.95 | $776.25 | $1,023.29 |
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 $478.63 Median $794.33 Typical High $1,412.54 | Professional | None | $478.63 | $794.33 | $1,412.54 |
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 $380.19 Median $380.19 Typical High $1,230.27 | Professional | 52 · Reduced service | $380.19 | $380.19 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $489.78 | Professional | 53 · Discontinued | $151.36 | $151.36 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $1,862.09 | Professional | 54 · Surgery only | $575.44 | $575.44 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $371.54 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $245.47 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $1,737.80 |
Where Ohio sits
The same service costs 3.1 times more in Wisconsin than in Hawaii. 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 $7,619HI $2,493
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.