How much rates vary
Facilitymedian $1,288 · 10th to 90th $525 to $5,888Professionalmedian $302 · 10th to 90th $186 to $550
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 $691.83 Median $4,365.16 Typical High $12,589.25 | Facility | None | $691.83 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $2,691.53 | Professional | None | $199.53 | $346.74 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,202.26 Typical High $4,570.88 | Facility | None | $524.81 | $1,202.26 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $257.04 Typical High $436.52 | Professional | None | $165.96 | $257.04 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $245.47 Median $933.25 Typical High $1,202.26 | Facility | None | $245.47 | $933.25 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,071.52 Typical High $1,995.26 | Facility | None | $489.78 | $1,071.52 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $316.23 Typical High $602.56 | Professional | None | $194.98 | $316.23 | $602.56 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,071.52 Typical High $1,995.26 | Facility | None | $512.86 | $1,071.52 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $630.96 | Professional | None | $194.98 | $309.03 | $630.96 |
Molina Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $549.54 | Professional | None | $316.23 | $407.38 | $549.54 |
SummaCare Setting Facility Modifier None Typical Low $512.86 Median $537.03 Typical High $616.60 | Facility | None | $512.86 | $537.03 | $616.60 |
SummaCare Setting Professional Modifier None Typical Low $181.97 Median $331.13 Typical High $436.52 | Professional | None | $181.97 | $331.13 | $436.52 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $5,888.44 | Facility | None | $691.83 | $1,445.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $588.84 | Professional | None | $208.93 | $309.03 | $588.84 |
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 $100.00 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $100.00 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $39.81 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $147.91 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $30.20 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $19.95 | $34.67 | $34.67 |
Where Ohio sits
The same service costs 7.9 times more in Oklahoma 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
OK $5,867MT $745
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.