How much rates vary
Facilitymedian $708 · 10th to 90th $129 to $4,169Professionalmedian $380 · 10th to 90th $50 to $631
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 $954.99 Median $2,691.53 Typical High $10,964.78 | Facility | None | $954.99 | $2,691.53 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $1,288.25 | Professional | None | $398.11 | $446.68 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $954.99 Typical High $3,715.35 | Facility | None | $416.87 | $954.99 | $3,715.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $524.81 | Professional | None | $199.53 | $234.42 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $512.86 | Facility | None | $125.89 | $162.18 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $245.47 Typical High $1,995.26 | Facility | None | $131.83 | $245.47 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $741.31 | Professional | None | $346.74 | $478.63 | $741.31 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $131.83 Median $234.42 Typical High $1,995.26 | Facility | None | $131.83 | $234.42 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $741.31 | Professional | None | $346.74 | $478.63 | $741.31 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $331.13 Typical High $588.84 | Professional | None | $33.88 | $331.13 | $588.84 |
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 $398.11 Median $501.19 Typical High $588.84 | Professional | None | $398.11 | $501.19 | $588.84 |
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 $239.88 Median $398.11 Typical High $660.69 | Professional | None | $239.88 | $398.11 | $660.69 |
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 $199.53 Median $218.78 Typical High $223.87 | Professional | 52 · Reduced service | $199.53 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $87.10 Typical High $89.13 | Professional | 53 · Discontinued | $79.43 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $331.13 Typical High $338.84 | Professional | 54 · Surgery only | $302.00 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $66.07 Typical High $67.61 | Professional | 55 · Aftercare only | $60.26 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $43.65 Typical High $44.67 | Professional | 56 · Pre-op care only | $39.81 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $309.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $281.84 | $309.03 | $316.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $295.12 Median $346.74 Typical High $776.25 | Professional | 50 · Both sides | $295.12 | $346.74 | $776.25 |
Where Ohio sits
The same service costs 5.3 times more in New York 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
NY $3,063DE $576
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.