How much rates vary
Facilitymedian $1,000 · 10th to 90th $427 to $9,333Professionalmedian $339 · 10th to 90th $275 to $661
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 $512.86 Median $10,232.93 Typical High $13,803.84 | Facility | None | $512.86 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $346.74 Typical High $9,120.11 | Professional | None | $338.84 | $346.74 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $489.78 | Professional | None | $275.42 | $323.59 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $707.95 | Professional | None | $302.00 | $380.19 | $707.95 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $707.95 | Professional | None | $302.00 | $380.19 | $707.95 |
Molina Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $389.05 | Professional | None | $257.04 | $309.03 | $389.05 |
SummaCare Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $549.54 | Professional | None | $288.40 | $316.23 | $549.54 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $933.25 | Professional | None | $323.59 | $446.68 | $933.25 |
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 $169.82 Median $169.82 Typical High $562.34 | Professional | 52 · Reduced service | $169.82 | $169.82 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $223.87 | Professional | 53 · Discontinued | $67.61 | $67.61 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $851.14 | Professional | 54 · Surgery only | $257.04 | $257.04 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $169.82 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $112.20 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $112.20 |
Where Ohio sits
The same service costs 6.1 times more in Alaska 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
AK $5,496MD $901
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.