How much rates vary
Facilitymedian $1,000 · 10th to 90th $380 to $4,786Professionalmedian $933 · 10th to 90th $117 to $1,585
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 $338.84 Median $3,388.44 Typical High $10,964.78 | Facility | None | $338.84 | $3,388.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $1,148.15 Typical High $1,348.96 | Professional | None | $117.49 | $1,148.15 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $933.25 Typical High $1,479.11 | Professional | None | $144.54 | $933.25 | $1,479.11 |
CareSource Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
CareSource Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $141.25 | Professional | None | $123.03 | $123.03 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $831.76 Typical High $4,677.35 | Facility | None | $575.44 | $831.76 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $323.59 Typical High $1,445.44 | Professional | None | $123.03 | $323.59 | $1,445.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $575.44 Median $831.76 Typical High $4,677.35 | Facility | None | $575.44 | $831.76 | $4,677.35 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $123.03 Median $323.59 Typical High $1,380.38 | Professional | None | $123.03 | $323.59 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,905.46 | Professional | None | $933.25 | $1,202.26 | $1,905.46 |
SummaCare Setting Facility Modifier None Typical Low $380.19 Median $398.11 Typical High $457.09 | Facility | None | $380.19 | $398.11 | $457.09 |
SummaCare Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $1,348.96 | Professional | None | $109.65 | $165.96 | $1,348.96 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,388.44 | Facility | None | $363.08 | $691.83 | $3,388.44 |
United Setting Professional Modifier None Typical Low $109.65 Median $741.31 Typical High $1,380.38 | Professional | None | $109.65 | $741.31 | $1,380.38 |
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 $57.54 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $57.54 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $23.44 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $851.14 Typical High $870.96 | Professional | 54 · Surgery only | $87.10 | $851.14 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $169.82 Typical High $173.78 | Professional | 55 · Aftercare only | $17.38 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $11.75 | $114.82 | $114.82 |
Where Ohio sits
The same service costs 5.5 times more in Hawaii than in Maryland. 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
HI $4,440MD $808
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.