How much rates vary
Facilitymedian $1,000 · 10th to 90th $427 to $9,333Professionalmedian $324 · 10th to 90th $224 to $525
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 $389.05 Median $10,232.93 Typical High $13,803.84 | Facility | None | $389.05 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $9,120.11 | Professional | None | $257.04 | $269.15 | $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 $269.15 Median $338.84 Typical High $489.78 | Professional | None | $269.15 | $338.84 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
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 $234.42 Median $288.40 Typical High $549.54 | Professional | None | $234.42 | $288.40 | $549.54 |
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 $234.42 Median $288.40 Typical High $549.54 | Professional | None | $234.42 | $288.40 | $549.54 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $295.12 | Professional | None | $190.55 | $234.42 | $295.12 |
SummaCare Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $426.58 | Professional | None | $223.87 | $245.47 | $426.58 |
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 $245.47 Median $346.74 Typical High $707.95 | Professional | None | $245.47 | $346.74 | $707.95 |
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 $128.82 Median $128.82 Typical High $436.52 | Professional | 52 · Reduced service | $128.82 | $128.82 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $177.83 | Professional | 53 · Discontinued | $52.48 | $52.48 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $660.69 | Professional | 54 · Surgery only | $194.98 | $194.98 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $131.83 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $87.10 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $87.10 |
Where Ohio sits
The same service costs 7.3 times more in Alaska 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
AK $5,199MT $710
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.