How much rates vary
Facilitymedian $1,288 · 10th to 90th $479 to $4,786Professionalmedian $417 · 10th to 90th $282 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 $512.86 Median $1,288.25 Typical High $10,715.19 | Facility | None | $512.86 | $1,288.25 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $1,479.11 | Professional | None | $275.42 | $380.19 | $1,479.11 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $478.63 | Professional | None | $407.38 | $407.38 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,148.15 Typical High $4,466.84 | Facility | None | $524.81 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $645.65 | Professional | None | $316.23 | $416.87 | $645.65 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $199.53 Median $263.03 Typical High $407.38 | Professional | 62 · Two surgeons | $199.53 | $263.03 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $354.81 Median $2,137.96 Typical High $2,818.38 | Facility | None | $354.81 | $2,137.96 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,187.76 Typical High $3,467.37 | Facility | None | $512.86 | $2,187.76 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $794.33 | Professional | None | $281.84 | $398.11 | $794.33 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $2,187.76 Typical High $3,467.37 | Facility | None | $512.86 | $2,187.76 | $3,467.37 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $794.33 | Professional | None | $281.84 | $398.11 | $794.33 |
Molina Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $602.56 | Professional | None | $346.74 | $446.68 | $602.56 |
SummaCare Setting Facility Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,412.54 | Facility | None | $1,174.90 | $1,230.27 | $1,412.54 |
SummaCare Setting Professional Modifier None Typical Low $245.47 Median $398.11 Typical High $524.81 | Professional | None | $245.47 | $398.11 | $524.81 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,388.44 | Facility | None | $363.08 | $691.83 | $3,388.44 |
United Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $794.33 | Professional | None | $275.42 | $426.58 | $794.33 |
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 $138.04 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $138.04 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $54.95 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $281.84 Typical High $288.40 | Professional | 54 · Surgery only | $204.17 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $40.74 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $27.54 | $38.02 | $38.02 |
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· 34th of 51
$447
AK $1,380NY $355
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.