How much rates vary
Facilitymedian $1,820 · 10th to 90th $631 to $8,710Professionalmedian $324 · 10th to 90th $245 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 $870.96 Median $5,754.40 Typical High $12,022.64 | Facility | None | $870.96 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $676.08 Typical High $9,120.11 | Professional | None | $338.84 | $676.08 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,548.82 Typical High $7,585.78 | Facility | None | $630.96 | $1,548.82 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $562.34 | Professional | None | $257.04 | $309.03 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $1,548.82 Typical High $1,995.26 | Facility | None | $380.19 | $1,548.82 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $2,884.03 | Facility | None | $549.54 | $1,737.80 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $660.69 | Professional | None | $295.12 | $371.54 | $660.69 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $2,884.03 | Facility | None | $549.54 | $1,737.80 | $2,884.03 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $676.08 | Professional | None | $295.12 | $371.54 | $676.08 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $380.19 | Professional | None | $229.09 | $288.40 | $380.19 |
SummaCare Setting Facility Modifier None Typical Low $831.76 Median $870.96 Typical High $1,000.00 | Facility | None | $831.76 | $870.96 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $537.03 | Professional | None | $281.84 | $309.03 | $537.03 |
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 $323.59 Median $407.38 Typical High $912.01 | Professional | None | $323.59 | $407.38 | $912.01 |
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 $169.82 Median $169.82 Typical High $426.58 | Professional | 52 · Reduced service | $169.82 | $169.82 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $173.78 | Professional | 53 · Discontinued | $67.61 | $67.61 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $645.65 | Professional | 54 · Surgery only | $257.04 | $257.04 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $128.82 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $85.11 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $602.56 |
Where Ohio sits
The same service costs 8.0 times more in Connecticut 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
CT $7,419MT $925
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.