How much rates vary
Facilitymedian $1,072 · 10th to 90th $468 to $4,677Professionalmedian $603 · 10th to 90th $89 to $977
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 $1,737.80 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,737.80 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $2,884.03 | Professional | None | $707.95 | $707.95 | $2,884.03 |
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 $588.84 Median $741.31 Typical High $1,174.90 | Professional | None | $588.84 | $741.31 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,096.48 Typical High $1,737.80 | Professional | 50 · Both sides | $891.25 | $1,096.48 | $1,737.80 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $954.99 Typical High $2,398.83 | Facility | None | $588.84 | $954.99 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,380.38 | Professional | None | $741.31 | $954.99 | $1,380.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $954.99 Typical High $2,398.83 | Facility | None | $588.84 | $954.99 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,380.38 | Professional | None | $741.31 | $954.99 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $489.78 Typical High $831.76 | Professional | None | $70.79 | $489.78 | $831.76 |
SummaCare Setting Facility Modifier None Typical Low $446.68 Median $467.74 Typical High $537.03 | Facility | None | $446.68 | $467.74 | $537.03 |
SummaCare Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $933.25 | Professional | None | $645.65 | $707.95 | $933.25 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $467.74 Median $794.33 Typical High $1,380.38 | Professional | None | $467.74 | $794.33 | $1,380.38 |
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 $354.81 Median $354.81 Typical High $1,258.93 | Professional | 52 · Reduced service | $354.81 | $354.81 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $501.19 | Professional | 53 · Discontinued | $141.25 | $141.25 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $1,905.46 | Professional | 54 · Surgery only | $537.03 | $537.03 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $380.19 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $251.19 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $1,778.28 |
Where Ohio sits
The same service costs 4.3 times more in Alaska than in Alabama. 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
AK $6,582AL $1,537
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.