How much rates vary
Facilitymedian $2,570 · 10th to 90th $562 to $7,943Professionalmedian $288 · 10th to 90th $186 to $437
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 $707.95 Median $4,365.16 Typical High $12,589.25 | Facility | None | $707.95 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $363.08 | Professional | None | $257.04 | $323.59 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $2,187.76 Typical High $7,079.46 | Facility | None | $660.69 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $407.38 | Professional | None | $223.87 | $288.40 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $316.23 Median $2,818.38 Typical High $3,630.78 | Facility | None | $316.23 | $2,818.38 | $3,630.78 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $302.00 | Professional | None | $269.15 | $269.15 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $2,818.38 Typical High $4,570.88 | Facility | None | $489.78 | $2,818.38 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $489.78 | Professional | None | $257.04 | $323.59 | $489.78 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $2,884.03 Typical High $4,466.84 | Facility | None | $512.86 | $2,884.03 | $4,466.84 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $478.63 | Professional | None | $257.04 | $323.59 | $478.63 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $257.04 Typical High $436.52 | Professional | None | $31.62 | $257.04 | $436.52 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $389.05 | Professional | None | $229.09 | $316.23 | $389.05 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $467.74 | Professional | None | $223.87 | $316.23 | $467.74 |
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 $128.82 Median $162.18 Typical High $165.96 | Professional | 52 · Reduced service | $128.82 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $64.57 Typical High $66.07 | Professional | 53 · Discontinued | $51.29 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $239.88 Typical High $245.47 | Professional | 54 · Surgery only | $190.55 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $47.86 Typical High $48.98 | Professional | 55 · Aftercare only | $38.02 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $32.36 Typical High $33.11 | Professional | 56 · Pre-op care only | $25.70 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $223.87 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $177.83 | $223.87 | $229.09 |
Where Ohio sits
The same service costs 8.7 times more in Alaska than in North Dakota. 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 $7,504ND $861
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.