How much rates vary
Facilitymedian $562 · 10th to 90th $275 to $3,715Professionalmedian $148 · 10th to 90th $91 to $251
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 $186.21 Median $562.34 Typical High $10,715.19 | Facility | None | $186.21 | $562.34 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $537.03 | Professional | None | $100.00 | $147.91 | $537.03 |
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 $83.18 Median $104.71 Typical High $165.96 | Professional | None | $83.18 | $104.71 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $363.08 Typical High $467.74 | Facility | None | $138.04 | $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 $123.03 Median $177.83 Typical High $251.19 | Professional | None | $123.03 | $177.83 | $251.19 |
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 $123.03 Median $177.83 Typical High $251.19 | Professional | None | $123.03 | $177.83 | $251.19 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $263.03 | Professional | None | $134.90 | $173.78 | $263.03 |
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 $104.71 Median $138.04 Typical High $199.53 | Professional | None | $104.71 | $138.04 | $199.53 |
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 $83.18 Median $144.54 Typical High $257.04 | Professional | None | $83.18 | $144.54 | $257.04 |
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 $50.12 Median $74.13 Typical High $83.18 | Professional | 52 · Reduced service | $50.12 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $29.51 Typical High $33.88 | Professional | 53 · Discontinued | $19.95 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $109.65 Typical High $125.89 | Professional | 54 · Surgery only | $75.86 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.88 Typical High $25.12 | Professional | 55 · Aftercare only | $15.14 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $14.79 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.00 | $14.79 | $16.60 |
Where Ohio sits
The same service costs 6.3 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 $2,712MT $427
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.