How much rates vary
Facilitymedian $5,888 · 10th to 90th $832 to $13,804Professionalmedian $4,786 · 10th to 90th $447 to $8,128
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 $1,288.25 Median $10,232.93 Typical High $17,782.79 | Facility | None | $1,288.25 | $10,232.93 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $5,370.32 Typical High $7,413.10 | Professional | None | $436.52 | $5,370.32 | $7,413.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $7,762.47 | Facility | None | $851.14 | $2,630.27 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $1,513.56 Typical High $8,128.31 | Professional | None | $426.58 | $1,513.56 | $8,128.31 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $6,918.31 Typical High $8,912.51 | Facility | None | $549.54 | $6,918.31 | $8,912.51 |
CareSource Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $524.81 | Professional | None | $467.74 | $467.74 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $7,244.36 Typical High $11,481.54 | Facility | None | $549.54 | $7,244.36 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $1,000.00 Typical High $7,943.28 | Professional | None | $457.09 | $1,000.00 | $7,943.28 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $7,244.36 Typical High $11,481.54 | Facility | None | $549.54 | $7,244.36 | $11,481.54 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $457.09 Median $1,000.00 Typical High $7,762.47 | Professional | None | $457.09 | $1,000.00 | $7,762.47 |
Molina Setting Professional Modifier None Typical Low $537.03 Median $4,786.30 Typical High $7,943.28 | Professional | None | $537.03 | $4,786.30 | $7,943.28 |
SummaCare Setting Facility Modifier None Typical Low $7,943.28 Median $8,317.64 Typical High $9,332.54 | Facility | None | $7,943.28 | $8,317.64 | $9,332.54 |
SummaCare Setting Professional Modifier None Typical Low $416.87 Median $630.96 Typical High $6,606.93 | Professional | None | $416.87 | $630.96 | $6,606.93 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $416.87 Median $4,570.88 Typical High $10,232.93 | Professional | None | $416.87 | $4,570.88 | $10,232.93 |
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 $218.78 Median $2,691.53 Typical High $2,951.21 | Professional | 52 · Reduced service | $218.78 | $2,691.53 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $1,071.52 Typical High $1,174.90 | Professional | 53 · Discontinued | $87.10 | $1,071.52 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $4,073.80 Typical High $4,466.84 | Professional | 54 · Surgery only | $323.59 | $4,073.80 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $812.83 Typical High $891.25 | Professional | 55 · Aftercare only | $66.07 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $537.03 Typical High $588.84 | Professional | 56 · Pre-op care only | $43.65 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $3,801.89 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $302.00 | $3,801.89 | $4,168.69 |
Where Ohio sits
The same service costs 4.1 times more in Iowa 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
IA $18,453DE $4,539
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.