How much rates vary
Facilitymedian $490 · 10th to 90th $79 to $3,548Professionalmedian $186 · 10th to 90th $76 to $417
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 $141.25 Median $776.25 Typical High $10,715.19 | Facility | None | $141.25 | $776.25 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $234.42 Typical High $776.25 | Professional | None | $77.62 | $234.42 | $776.25 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
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 $66.07 Median $77.62 Typical High $131.83 | Professional | None | $66.07 | $77.62 | $131.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $97.72 Median $114.82 Typical High $190.55 | Professional | 50 · Both sides | $97.72 | $114.82 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $67.61 Median $87.10 Typical High $95.50 | Facility | None | $67.61 | $87.10 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $131.83 Typical High $1,479.11 | Facility | None | $72.44 | $131.83 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $223.87 Typical High $380.19 | Professional | None | $81.28 | $223.87 | $380.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $72.44 Median $131.83 Typical High $1,479.11 | Facility | None | $72.44 | $131.83 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $81.28 Median $223.87 Typical High $380.19 | Professional | None | $81.28 | $223.87 | $380.19 |
Molina Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $436.52 | Professional | None | $239.88 | $323.59 | $436.52 |
SummaCare Setting Facility Modifier None Typical Low $38.02 Median $39.81 Typical High $44.67 | Facility | None | $38.02 | $39.81 | $44.67 |
SummaCare Setting Professional Modifier None Typical Low $72.44 Median $263.03 Typical High $407.38 | Professional | None | $72.44 | $263.03 | $407.38 |
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 $72.44 Median $162.18 Typical High $398.11 | Professional | None | $72.44 | $162.18 | $398.11 |
5 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 $38.02 Median $114.82 Typical High $120.23 | Professional | 52 · Reduced service | $38.02 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $46.77 Typical High $47.86 | Professional | 53 · Discontinued | $15.49 | $46.77 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $173.78 Typical High $181.97 | Professional | 54 · Surgery only | $57.54 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $34.67 Typical High $36.31 | Professional | 55 · Aftercare only | $11.48 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $23.44 Typical High $23.99 | Professional | 56 · Pre-op care only | $7.76 | $23.44 | $23.99 |
Where Ohio sits
The same service costs 9.4 times more in New York than in Maryland. 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 $2,695MD $285
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.