How much rates vary
Facilitymedian $2,692 · 10th to 90th $741 to $10,233Professionalmedian $741 · 10th to 90th $120 to $1,230
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 $933.25 Median $933.25 Typical High $4,168.69 | Professional | None | $933.25 | $933.25 | $4,168.69 |
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 $660.69 Median $812.83 Typical High $1,380.38 | Professional | None | $660.69 | $812.83 | $1,380.38 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $1,995.26 | Facility | None | $1,174.90 | $1,513.56 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,778.28 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $630.96 Typical High $1,148.15 | Professional | None | $104.71 | $630.96 | $1,148.15 |
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 $851.14 Median $933.25 Typical High $1,230.27 | Professional | None | $851.14 | $933.25 | $1,230.27 |
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 $588.84 Median $954.99 Typical High $1,698.24 | Professional | None | $588.84 | $954.99 | $1,698.24 |
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 $457.09 Median $457.09 Typical High $1,659.59 | Professional | 52 · Reduced service | $457.09 | $457.09 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $676.08 | Professional | 53 · Discontinued | $186.21 | $186.21 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $2,511.89 | Professional | 54 · Surgery only | $691.83 | $691.83 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $501.19 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $331.13 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $2,344.23 |
Where Ohio sits
The same service costs 3.4 times more in Wisconsin than in Kansas. 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 $9,117KS $2,643
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.