How much rates vary
Facilitymedian $550 · 10th to 90th $126 to $3,715Professionalmedian $437 · 10th to 90th $51 to $692
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 $616.60 Median $3,235.94 Typical High $12,589.25 | Facility | None | $616.60 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $1,548.82 | Professional | None | $446.68 | $478.63 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $831.76 Typical High $3,311.31 | Facility | None | $371.54 | $831.76 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $630.96 | Professional | None | $316.23 | $398.11 | $630.96 |
Aultcare Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $562.34 | Facility | None | $125.89 | $162.18 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $245.47 Typical High $1,479.11 | Facility | None | $131.83 | $245.47 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $812.83 | Professional | None | $446.68 | $549.54 | $812.83 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $131.83 Median $234.42 Typical High $1,479.11 | Facility | None | $131.83 | $234.42 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $812.83 | Professional | None | $446.68 | $549.54 | $812.83 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $354.81 Typical High $630.96 | Professional | None | $33.88 | $354.81 | $630.96 |
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 $446.68 Median $537.03 Typical High $630.96 | Professional | None | $446.68 | $537.03 | $630.96 |
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 $295.12 Median $467.74 Typical High $812.83 | Professional | None | $295.12 | $467.74 | $812.83 |
7 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 $218.78 Median $234.42 Typical High $257.04 | Professional | 52 · Reduced service | $218.78 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $95.50 Typical High $102.33 | Professional | 53 · Discontinued | $89.13 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $354.81 Typical High $389.05 | Professional | 54 · Surgery only | $331.13 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $77.62 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $47.86 Typical High $51.29 | Professional | 56 · Pre-op care only | $44.67 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $331.13 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $309.03 | $331.13 | $363.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $588.84 Typical High $954.99 | Professional | 50 · Both sides | $478.63 | $588.84 | $954.99 |
Where Ohio sits
The same service costs 4.9 times more in Connecticut 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
CT $3,107FL $640
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.