How much rates vary
Facilitymedian $3,090 · 10th to 90th $661 to $9,333Professionalmedian $355 · 10th to 90th $282 to $537
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 $1,698.24 Median $7,244.36 Typical High $12,589.25 | Facility | None | $1,698.24 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $1,659.59 | Professional | None | $323.59 | $323.59 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $7,585.78 | Facility | None | $630.96 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $512.86 | Professional | None | $323.59 | $380.19 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $407.38 Median $2,041.74 Typical High $2,691.53 | Facility | None | $407.38 | $2,041.74 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $389.05 | Professional | None | $346.74 | $346.74 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,073.80 Typical High $6,456.54 | Facility | None | $602.56 | $4,073.80 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $691.83 | Professional | None | $316.23 | $354.81 | $691.83 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $4,073.80 Typical High $6,309.57 | Facility | None | $602.56 | $4,073.80 | $6,309.57 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $676.08 | Professional | None | $316.23 | $354.81 | $676.08 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $478.63 | Professional | None | $251.19 | $316.23 | $478.63 |
SummaCare Setting Facility Modifier None Typical Low $2,187.76 Median $2,290.87 Typical High $2,630.27 | Facility | None | $2,187.76 | $2,290.87 | $2,630.27 |
SummaCare Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $575.44 | Professional | None | $275.42 | $389.05 | $575.44 |
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 $162.18 Median $162.18 Typical High $213.80 | Professional | 52 · Reduced service | $162.18 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $85.11 | Professional | 53 · Discontinued | $66.07 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $316.23 | Professional | 54 · Surgery only | $245.47 | $245.47 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $64.57 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $42.66 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $42.66 |
Where Ohio sits
The same service costs 7.2 times more in Wisconsin 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
WI $7,422MT $1,038
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.