How much rates vary
Facilitymedian $537 · 10th to 90th $123 to $4,169Professionalmedian $132 · 10th to 90th $91 to $209
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 $281.84 Median $2,691.53 Typical High $10,964.78 | Facility | None | $281.84 | $2,691.53 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $338.84 | Professional | None | $107.15 | $154.88 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $831.76 Typical High $3,715.35 | Facility | None | $407.38 | $831.76 | $3,715.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $177.83 | Professional | None | $81.28 | $117.49 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $131.83 Typical High $154.88 | Facility | None | $120.23 | $131.83 | $154.88 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $128.82 | Professional | None | $112.20 | $112.20 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $234.42 Typical High $1,995.26 | Facility | None | $125.89 | $234.42 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $245.47 | Professional | None | $104.71 | $154.88 | $245.47 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $125.89 Median $223.87 Typical High $1,995.26 | Facility | None | $125.89 | $223.87 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $239.88 | Professional | None | $104.71 | $154.88 | $239.88 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $213.80 | Professional | None | $107.15 | $134.90 | $213.80 |
SummaCare Setting Facility Modifier None Typical Low $66.07 Median $69.18 Typical High $79.43 | Facility | None | $66.07 | $69.18 | $79.43 |
SummaCare Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $186.21 | Professional | None | $100.00 | $151.36 | $186.21 |
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 $91.20 Median $134.90 Typical High $213.80 | Professional | None | $91.20 | $134.90 | $213.80 |
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 $53.70 Median $77.62 Typical High $79.43 | Professional | 52 · Reduced service | $53.70 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $30.90 Typical High $31.62 | Professional | 53 · Discontinued | $21.38 | $30.90 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $114.82 Typical High $117.49 | Professional | 54 · Surgery only | $79.43 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $22.91 Typical High $23.44 | Professional | 55 · Aftercare only | $16.22 | $22.91 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.49 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.72 | $15.49 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $107.15 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $74.13 | $107.15 | $109.65 |
Where Ohio sits
The same service costs 9.1 times more in New York than in Delaware. 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 $2,759DE $302
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.