How much rates vary
Facilitymedian $692 · 10th to 90th $355 to $4,074Professionalmedian $126 · 10th to 90th $98 to $224
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 $1,000.00 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,000.00 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $3,715.35 | Professional | None | $97.72 | $97.72 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $912.01 Typical High $3,388.44 | Facility | None | $389.05 | $912.01 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $194.98 | Professional | None | $104.71 | $123.03 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $363.08 Typical High $467.74 | Facility | None | $141.25 | $363.08 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $436.52 Typical High $1,479.11 | Facility | None | $354.81 | $436.52 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $302.00 | Professional | None | $112.20 | $138.04 | $302.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $354.81 Median $436.52 Typical High $1,479.11 | Facility | None | $354.81 | $436.52 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $302.00 | Professional | None | $112.20 | $138.04 | $302.00 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $165.96 | Professional | None | $97.72 | $123.03 | $165.96 |
SummaCare Setting Facility Modifier None Typical Low $199.53 Median $208.93 Typical High $239.88 | Facility | None | $199.53 | $208.93 | $239.88 |
SummaCare Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $177.83 | Professional | None | $107.15 | $107.15 | $177.83 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,311.31 | Facility | None | $363.08 | $691.83 | $3,311.31 |
United Setting Professional Modifier None Typical Low $102.33 Median $158.49 Typical High $269.15 | Professional | None | $102.33 | $158.49 | $269.15 |
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 $48.98 Median $48.98 Typical High $302.00 | Professional | 52 · Reduced service | $48.98 | $48.98 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $120.23 | Professional | 53 · Discontinued | $19.95 | $19.95 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $457.09 | Professional | 54 · Surgery only | $74.13 | $74.13 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $91.20 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $60.26 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $60.26 |
Where Ohio sits
The same service costs 8.1 times more in New York 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
NY $2,852MT $352
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.