How much rates vary
Facilitymedian $2,692 · 10th to 90th $708 to $9,333Professionalmedian $427 · 10th to 90th $339 to $759
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 $707.95 Median $5,128.61 Typical High $12,589.25 | Facility | None | $707.95 | $5,128.61 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $8,128.31 | Professional | None | $389.05 | $501.19 | $8,128.31 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $512.86 | Professional | None | $354.81 | $512.86 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,290.87 Typical High $7,762.47 | Facility | None | $758.58 | $2,290.87 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $676.08 | Professional | None | $338.84 | $398.11 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $588.84 Typical High $1,000.00 | Professional | 50 · Both sides | $501.19 | $588.84 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $478.63 Median $2,454.71 Typical High $3,162.28 | Facility | None | $478.63 | $2,454.71 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,818.38 Typical High $4,365.16 | Facility | None | $676.08 | $2,818.38 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $794.33 | Professional | None | $354.81 | $426.58 | $794.33 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $2,884.03 Typical High $4,570.88 | Facility | None | $741.31 | $2,884.03 | $4,570.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $812.83 | Professional | None | $354.81 | $426.58 | $812.83 |
Molina Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $562.34 | Professional | None | $331.13 | $416.87 | $562.34 |
SummaCare Setting Facility Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,659.59 | Facility | None | $1,412.54 | $1,479.11 | $1,659.59 |
SummaCare Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $602.56 | Professional | None | $354.81 | $354.81 | $602.56 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,630.27 Typical High $9,120.11 | Facility | None | $831.76 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $933.25 | Professional | None | $371.54 | $478.63 | $933.25 |
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 $194.98 Median $194.98 Typical High $676.08 | Professional | 52 · Reduced service | $194.98 | $194.98 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $269.15 | Professional | 53 · Discontinued | $77.62 | $77.62 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $1,023.29 | Professional | 54 · Surgery only | $288.40 | $288.40 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $204.17 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $134.90 |
Where Ohio sits
The same service costs 7.3 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 $8,816MT $1,205
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.