How much rates vary
Facilitymedian $562 · 10th to 90th $126 to $3,715Professionalmedian $479 · 10th to 90th $85 to $776
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 $660.69 Median $3,235.94 Typical High $12,589.25 | Facility | None | $660.69 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $2,290.87 | Professional | None | $467.74 | $501.19 | $2,290.87 |
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 $331.13 Median $416.87 Typical High $707.95 | Professional | None | $331.13 | $416.87 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $588.84 | Facility | None | $125.89 | $162.18 | $588.84 |
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 $489.78 Median $602.56 Typical High $891.25 | Professional | None | $489.78 | $602.56 | $891.25 |
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 $489.78 Median $616.60 Typical High $891.25 | Professional | None | $489.78 | $616.60 | $891.25 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $426.58 Typical High $724.44 | Professional | None | $70.79 | $426.58 | $724.44 |
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 $524.81 Median $616.60 Typical High $724.44 | Professional | None | $524.81 | $616.60 | $724.44 |
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 $323.59 Median $501.19 Typical High $870.96 | Professional | None | $323.59 | $501.19 | $870.96 |
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 $229.09 Median $251.19 Typical High $275.42 | Professional | 52 · Reduced service | $229.09 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $100.00 Typical High $109.65 | Professional | 53 · Discontinued | $93.33 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $380.19 Typical High $407.38 | Professional | 54 · Surgery only | $346.74 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $75.86 Typical High $81.28 | Professional | 55 · Aftercare only | $69.18 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $50.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $46.77 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $354.81 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $323.59 | $354.81 | $380.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $616.60 Typical High $1,047.13 | Professional | 50 · Both sides | $501.19 | $616.60 | $1,047.13 |
Where Ohio sits
The same service costs 5.2 times more in Connecticut than in Delaware. 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 $3,468DE $666
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.