How much rates vary
Facilitymedian $550 · 10th to 90th $129 to $3,715Professionalmedian $224 · 10th to 90th $129 to $380
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 $371.54 Median $1,995.26 Typical High $10,964.78 | Facility | None | $371.54 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $1,905.46 | Professional | None | $138.04 | $223.87 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $831.76 Typical High $3,311.31 | Facility | None | $371.54 | $831.76 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $323.59 | Professional | None | $128.82 | $190.55 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $165.96 Typical High $165.96 | Facility | None | $125.89 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $245.47 Typical High $1,479.11 | Facility | None | $134.90 | $245.47 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $398.11 | Professional | None | $128.82 | $204.17 | $398.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $134.90 Median $239.88 Typical High $1,479.11 | Facility | None | $134.90 | $239.88 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $398.11 | Professional | None | $128.82 | $208.93 | $398.11 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $380.19 | Professional | None | $213.80 | $281.84 | $380.19 |
SummaCare Setting Facility Modifier None Typical Low $70.79 Median $74.13 Typical High $85.11 | Facility | None | $70.79 | $74.13 | $85.11 |
SummaCare Setting Professional Modifier None Typical Low $131.83 Median $251.19 Typical High $323.59 | Professional | None | $131.83 | $251.19 | $323.59 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $389.05 | Professional | None | $128.82 | $213.80 | $389.05 |
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 $69.18 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $69.18 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $27.54 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $169.82 Typical High $169.82 | Professional | 54 · Surgery only | $104.71 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $20.89 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $13.80 | $22.39 | $22.39 |
Where Ohio sits
The same service costs 8.8 times more in New York than in Alabama. 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
NY $2,761AL $314
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.