How much rates vary
Facilitymedian $2,512 · 10th to 90th $589 to $8,710Professionalmedian $617 · 10th to 90th $490 to $1,047
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 $1,737.80 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,737.80 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $4,168.69 | Professional | None | $562.34 | $562.34 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $2,137.96 Typical High $7,079.46 | Facility | None | $724.44 | $2,137.96 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $1,047.13 | Professional | None | $478.63 | $588.84 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $891.25 Typical High $1,548.82 | Professional | 50 · Both sides | $724.44 | $891.25 | $1,548.82 |
CareSource Setting Facility Modifier None Typical Low $691.83 Median $4,570.88 Typical High $6,025.60 | Facility | None | $691.83 | $4,570.88 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $4,786.30 Typical High $7,585.78 | Facility | None | $524.81 | $4,786.30 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $1,148.15 | Professional | None | $512.86 | $616.60 | $1,148.15 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $537.03 Median $4,786.30 Typical High $7,585.78 | Facility | None | $537.03 | $4,786.30 | $7,585.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $1,148.15 | Professional | None | $512.86 | $616.60 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $831.76 | Professional | None | $489.78 | $630.96 | $831.76 |
SummaCare Setting Facility Modifier None Typical Low $2,570.40 Median $2,691.53 Typical High $3,090.30 | Facility | None | $2,570.40 | $2,691.53 | $3,090.30 |
SummaCare Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $812.83 | Professional | None | $512.86 | $512.86 | $812.83 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,786.30 | Facility | None | $501.19 | $977.24 | $4,786.30 |
United Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,348.96 | Professional | None | $537.03 | $660.69 | $1,348.96 |
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 $275.42 Median $275.42 Typical High $1,174.90 | Professional | 52 · Reduced service | $275.42 | $275.42 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $478.63 | Professional | 53 · Discontinued | $112.20 | $112.20 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $1,778.28 | Professional | 54 · Surgery only | $416.87 | $416.87 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $354.81 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $234.42 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $234.42 |
Where Ohio sits
The same service costs 3.9 times more in Alaska than in New York. 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.
Ohio· 45th of 51
$646
AK $2,239NY $575
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.