How much rates vary
Facilitymedian $1,862 · 10th to 90th $661 to $8,511Professionalmedian $398 · 10th to 90th $79 to $617
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 $1,202.26 Median $5,754.40 Typical High $12,022.64 | Facility | None | $1,202.26 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $4,168.69 | Professional | None | $436.52 | $436.52 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $7,585.78 | Facility | None | $630.96 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $676.08 | Professional | None | $338.84 | $416.87 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $630.96 Typical High $1,000.00 | Professional | 50 · Both sides | $501.19 | $630.96 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $1,995.26 | Facility | None | $562.34 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,737.80 Typical High $2,691.53 | Facility | None | $575.44 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $831.76 | Professional | None | $446.68 | $562.34 | $831.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $831.76 | Professional | None | $446.68 | $562.34 | $831.76 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $338.84 Typical High $524.81 | Professional | None | $67.61 | $338.84 | $524.81 |
SummaCare Setting Facility Modifier None Typical Low $851.14 Median $891.25 Typical High $1,000.00 | Facility | None | $851.14 | $891.25 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $575.44 | Professional | None | $398.11 | $446.68 | $575.44 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $281.84 Median $478.63 Typical High $812.83 | Professional | None | $281.84 | $478.63 | $812.83 |
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 $218.78 Median $218.78 Typical High $912.01 | Professional | 52 · Reduced service | $218.78 | $218.78 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $363.08 | Professional | 53 · Discontinued | $87.10 | $87.10 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $1,348.96 | Professional | 54 · Surgery only | $331.13 | $331.13 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $269.15 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $181.97 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $1,258.93 |
Where Ohio sits
The same service costs 4.9 times more in Wisconsin 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
WI $7,341MT $1,483
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.