How much rates vary
Facilitymedian $1,202 · 10th to 90th $631 to $8,128Professionalmedian $398 · 10th to 90th $85 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 $630.96 Median $1,737.80 Typical High $12,022.64 | Facility | None | $630.96 | $1,737.80 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $1,174.90 | Professional | None | $309.03 | $446.68 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,148.15 Typical High $4,786.30 | Facility | None | $630.96 | $1,148.15 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $478.63 | Professional | None | $199.53 | $234.42 | $478.63 |
Aultcare Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $891.25 Typical High $1,174.90 | Facility | None | $446.68 | $891.25 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,047.13 Typical High $2,951.21 | Facility | None | $741.31 | $1,047.13 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $776.25 | Professional | None | $354.81 | $524.81 | $776.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $1,047.13 Typical High $2,951.21 | Facility | None | $741.31 | $1,047.13 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $758.58 | Professional | None | $354.81 | $524.81 | $758.58 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $363.08 Typical High $660.69 | Professional | None | $69.18 | $363.08 | $660.69 |
SummaCare Setting Facility Modifier None Typical Low $489.78 Median $512.86 Typical High $588.84 | Facility | None | $489.78 | $512.86 | $588.84 |
SummaCare Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $676.08 | Professional | None | $346.74 | $537.03 | $676.08 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $5,888.44 | Facility | None | $691.83 | $1,445.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $776.25 | Professional | None | $275.42 | $426.58 | $776.25 |
8 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 $173.78 Median $251.19 Typical High $269.15 | Professional | 52 · Reduced service | $173.78 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $100.00 Typical High $107.15 | Professional | 53 · Discontinued | $69.18 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $371.54 Typical High $398.11 | Professional | 54 · Surgery only | $263.03 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $74.13 Typical High $79.43 | Professional | 55 · Aftercare only | $52.48 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $50.12 Typical High $53.70 | Professional | 56 · Pre-op care only | $34.67 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $346.74 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $245.47 | $346.74 | $371.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $295.12 Median $346.74 Typical High $707.95 | Professional | 50 · Both sides | $295.12 | $346.74 | $707.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $125.89 Median $147.91 Typical High $302.00 | Professional | 62 · Two surgeons | $125.89 | $147.91 | $302.00 |
Where Ohio sits
The same service costs 3.9 times more in Alabama than in Montana. 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
AL $5,160MT $1,330
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.