How much rates vary
Facilitymedian $2,239 · 10th to 90th $661 to $8,913Professionalmedian $631 · 10th to 90th $457 to $1,122
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 $1,258.93 Median $5,128.61 Typical High $12,589.25 | Facility | None | $1,258.93 | $5,128.61 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $1,258.93 Typical High $8,912.51 | Professional | None | $691.83 | $1,258.93 | $8,912.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $1,000.00 | Professional | None | $501.19 | $630.96 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $1,905.46 Typical High $2,454.71 | Facility | None | $776.25 | $1,905.46 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,238.72 Typical High $4,570.88 | Facility | None | $549.54 | $2,238.72 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,380.38 | Professional | None | $602.56 | $776.25 | $1,380.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $2,238.72 Typical High $4,570.88 | Facility | None | $549.54 | $2,238.72 | $4,570.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,412.54 | Professional | None | $602.56 | $776.25 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $389.05 Median $575.44 Typical High $776.25 | Professional | None | $389.05 | $575.44 | $776.25 |
SummaCare Setting Facility Modifier None Typical Low $2,137.96 Median $2,238.72 Typical High $2,570.40 | Facility | None | $2,137.96 | $2,238.72 | $2,570.40 |
SummaCare Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $1,096.48 | Professional | None | $575.44 | $630.96 | $1,096.48 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,862.09 | Professional | None | $660.69 | $851.14 | $1,862.09 |
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 $346.74 Median $346.74 Typical High $954.99 | Professional | 52 · Reduced service | $346.74 | $346.74 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $380.19 | Professional | 53 · Discontinued | $138.04 | $138.04 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $1,445.44 | Professional | 54 · Surgery only | $524.81 | $524.81 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $288.40 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $190.55 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $1,348.96 |
Where Ohio sits
The same service costs 4.7 times more in Wisconsin than in Kentucky. 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 $8,213KY $1,765
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.