How much rates vary
Facilitymedian $3,090 · 10th to 90th $501 to $11,749Professionalmedian $851 · 10th to 90th $132 to $1,380
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 $2,290.87 Median $5,011.87 Typical High $12,589.25 | Facility | None | $2,290.87 | $5,011.87 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $6,760.83 | Professional | None | $831.76 | $831.76 | $6,760.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $6,165.95 Typical High $12,882.50 | Facility | None | $891.25 | $6,165.95 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,445.44 | Professional | None | $630.96 | $794.33 | $1,445.44 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,905.46 | Professional | None | $891.25 | $1,174.90 | $1,905.46 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,905.46 | Professional | None | $891.25 | $1,174.90 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $794.33 Typical High $1,288.25 | Professional | None | $120.23 | $794.33 | $1,288.25 |
SummaCare Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,412.54 | Professional | None | $933.25 | $933.25 | $1,412.54 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $2,238.72 | Professional | None | $831.76 | $1,148.15 | $2,238.72 |
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 $407.38 Median $407.38 Typical High $2,398.83 | Professional | 52 · Reduced service | $407.38 | $407.38 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $977.24 | Professional | 53 · Discontinued | $165.96 | $165.96 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $3,630.78 | Professional | 54 · Surgery only | $616.60 | $616.60 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $724.44 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $478.63 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $3,388.44 |
Where Ohio sits
The same service costs 10.1 times more in Maine than in Arkansas. 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
ME $16,050AR $1,584
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.