How much rates vary
Facilitymedian $550 · 10th to 90th $126 to $3,715Professionalmedian $339 · 10th to 90th $44 to $589
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 $1,380.38 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,380.38 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $2,344.23 | Professional | None | $380.19 | $380.19 | $2,344.23 |
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 $257.04 Median $316.23 Typical High $602.56 | Professional | None | $257.04 | $316.23 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $478.63 Typical High $891.25 | Professional | 50 · Both sides | $380.19 | $478.63 | $891.25 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $489.78 | Facility | None | $125.89 | $162.18 | $489.78 |
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 $380.19 Median $467.74 Typical High $676.08 | Professional | None | $380.19 | $467.74 | $676.08 |
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 $380.19 Median $467.74 Typical High $676.08 | Professional | None | $380.19 | $467.74 | $676.08 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $302.00 Typical High $549.54 | Professional | None | $33.88 | $302.00 | $549.54 |
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 $407.38 Median $457.09 Typical High $562.34 | Professional | None | $407.38 | $457.09 | $562.34 |
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 $234.42 Median $380.19 Typical High $691.83 | Professional | None | $234.42 | $380.19 | $691.83 |
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 $190.55 Median $190.55 Typical High $954.99 | Professional | 52 · Reduced service | $190.55 | $190.55 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $380.19 | Professional | 53 · Discontinued | $75.86 | $75.86 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $1,412.54 | Professional | 54 · Surgery only | $288.40 | $288.40 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $288.40 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $190.55 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $1,318.26 |
Where Ohio sits
The same service costs 6.4 times more in Connecticut than in Texas. 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 $3,322TX $515
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.