How much rates vary
Facilitymedian $501 · 10th to 90th $95 to $3,631Professionalmedian $275 · 10th to 90th $51 to $479
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 $489.78 Median $891.25 Typical High $12,022.64 | Facility | None | $489.78 | $891.25 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $891.25 | Professional | None | $269.15 | $316.23 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $398.11 | Professional | None | $190.55 | $239.88 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $346.74 | Facility | None | $125.89 | $162.18 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $144.54 Typical High $245.47 | Facility | None | $58.88 | $144.54 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $549.54 | Professional | None | $275.42 | $354.81 | $549.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $144.54 Typical High $245.47 | Facility | None | $58.88 | $144.54 | $245.47 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $537.03 | Professional | None | $275.42 | $354.81 | $537.03 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $239.88 Typical High $457.09 | Professional | None | $33.88 | $239.88 | $457.09 |
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 $302.00 Median $371.54 Typical High $446.68 | Professional | None | $302.00 | $371.54 | $446.68 |
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 $186.21 Median $288.40 Typical High $512.86 | Professional | None | $186.21 | $288.40 | $512.86 |
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 $134.90 Median $158.49 Typical High $169.82 | Professional | 52 · Reduced service | $134.90 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $63.10 Typical High $67.61 | Professional | 53 · Discontinued | $54.95 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $234.42 Typical High $251.19 | Professional | 54 · Surgery only | $204.17 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $47.86 Typical High $51.29 | Professional | 55 · Aftercare only | $40.74 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $31.62 Typical High $33.88 | Professional | 56 · Pre-op care only | $26.92 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $218.78 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $190.55 | $218.78 | $234.42 |
Where Ohio sits
The same service costs 6.7 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 $2,828FL $419
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.