How much rates vary
Facilitymedian $1,820 · 10th to 90th $851 to $10,000Professionalmedian $389 · 10th to 90th $81 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 $851.14 Median $7,413.10 Typical High $12,589.25 | Facility | None | $851.14 | $7,413.10 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $2,344.23 | Professional | None | $467.74 | $467.74 | $2,344.23 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $912.01 | Professional | None | $436.52 | $436.52 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $1,819.70 Typical High $7,762.47 | Facility | None | $812.83 | $1,819.70 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $724.44 | Professional | None | $354.81 | $436.52 | $724.44 |
Aultcare Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $870.96 | Professional | None | $524.81 | $616.60 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $588.84 Median $1,513.56 Typical High $1,995.26 | Facility | None | $588.84 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $4,677.35 | Facility | None | $1,071.52 | $1,778.28 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $870.96 | Professional | None | $467.74 | $588.84 | $870.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $4,677.35 | Facility | None | $1,096.48 | $1,778.28 | $4,677.35 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $870.96 | Professional | None | $467.74 | $588.84 | $870.96 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $323.59 Typical High $537.03 | Professional | None | $70.79 | $323.59 | $537.03 |
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 $436.52 Median $457.09 Typical High $724.44 | Professional | None | $436.52 | $457.09 | $724.44 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $295.12 Median $489.78 Typical High $851.14 | Professional | None | $295.12 | $489.78 | $851.14 |
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 $234.42 Median $234.42 Typical High $575.44 | Professional | 52 · Reduced service | $234.42 | $234.42 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $229.09 | Professional | 53 · Discontinued | $93.33 | $93.33 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $870.96 | Professional | 54 · Surgery only | $346.74 | $346.74 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $173.78 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $114.82 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $812.83 |
Where Ohio sits
The same service costs 5.4 times more in Alabama 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
AL $8,312MT $1,553
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.