How much rates vary
Facilitymedian $1,445 · 10th to 90th $603 to $7,762Professionalmedian $525 · 10th to 90th $91 to $912
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 $1,862.09 Median $7,244.36 Typical High $12,589.25 | Facility | None | $1,862.09 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $1,819.70 | Professional | None | $575.44 | $676.08 | $1,819.70 |
Ambetter Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $1,584.89 Typical High $7,585.78 | Facility | None | $616.60 | $1,584.89 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $912.01 | Professional | None | $363.08 | $426.58 | $912.01 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,513.56 | Facility | None | $870.96 | $1,174.90 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $2,398.83 | Facility | None | $602.56 | $1,318.26 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,348.96 | Professional | None | $707.95 | $912.01 | $1,348.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $2,398.83 | Facility | None | $602.56 | $1,318.26 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,348.96 | Professional | None | $707.95 | $912.01 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $446.68 Typical High $776.25 | Professional | None | $70.79 | $446.68 | $776.25 |
SummaCare Setting Facility Modifier None Typical Low $645.65 Median $676.08 Typical High $758.58 | Facility | None | $645.65 | $676.08 | $758.58 |
SummaCare Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $891.25 | Professional | None | $616.60 | $676.08 | $891.25 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,786.30 | Facility | None | $501.19 | $977.24 | $4,786.30 |
United Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $1,288.25 | Professional | None | $489.78 | $776.25 | $1,288.25 |
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 $338.84 Median $338.84 Typical High $912.01 | Professional | 52 · Reduced service | $338.84 | $338.84 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $363.08 | Professional | 53 · Discontinued | $134.90 | $134.90 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $1,380.38 | Professional | 54 · Surgery only | $512.86 | $512.86 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $275.42 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $181.97 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $630.96 Typical High $1,348.96 | Professional | 50 · Both sides | $537.03 | $630.96 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $229.09 Median $269.15 Typical High $575.44 | Professional | 62 · Two surgeons | $229.09 | $269.15 | $575.44 |
Where Ohio sits
The same service costs 5.4 times more in Alabama 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
AL $8,418DE $1,559
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.