How much rates vary
Facilitymedian $1,820 · 10th to 90th $617 to $7,943Professionalmedian $347 · 10th to 90th $234 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 $616.60 Median $4,168.69 Typical High $11,220.18 | Facility | None | $616.60 | $4,168.69 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $7,079.46 | Professional | None | $338.84 | $407.38 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,318.26 Typical High $4,786.30 | Facility | None | $575.44 | $1,318.26 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $537.03 | Professional | None | $269.15 | $331.13 | $537.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $512.86 Typical High $812.83 | Professional | 50 · Both sides | $398.11 | $512.86 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $407.38 Median $1,584.89 Typical High $2,089.30 | Facility | None | $407.38 | $1,584.89 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,754.23 | Facility | None | $602.56 | $1,819.70 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $660.69 | Professional | None | $295.12 | $354.81 | $660.69 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,691.53 | Facility | None | $602.56 | $1,819.70 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $676.08 | Professional | None | $295.12 | $354.81 | $676.08 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $338.84 Typical High $467.74 | Professional | None | $47.86 | $338.84 | $467.74 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,047.13 | Facility | None | $891.25 | $933.25 | $1,047.13 |
SummaCare Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $467.74 | Professional | None | $309.03 | $309.03 | $467.74 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $758.58 | Professional | None | $295.12 | $371.54 | $758.58 |
6 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 $169.82 Median $169.82 Typical High $630.96 | Professional | 52 · Reduced service | $169.82 | $169.82 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $251.19 | Professional | 53 · Discontinued | $67.61 | $67.61 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $933.25 | Professional | 54 · Surgery only | $251.19 | $251.19 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $190.55 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $125.89 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $870.96 |
Where Ohio sits
The same service costs 5.3 times more in Alaska 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
AK $5,518MT $1,050
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.