How much rates vary
Facilitymedian $617 · 10th to 90th $240 to $3,715Professionalmedian $129 · 10th to 90th $71 to $234
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 $128.82 Median $501.19 Typical High $10,715.19 | Facility | None | $128.82 | $501.19 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $117.49 Typical High $676.08 | Professional | None | $70.79 | $117.49 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $131.83 | Professional | None | $70.79 | $89.13 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $457.09 Typical High $602.56 | Facility | None | $95.50 | $457.09 | $602.56 |
CareSource Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $190.55 | Professional | None | $120.23 | $154.88 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $588.84 Typical High $1,479.11 | Facility | None | $457.09 | $588.84 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $213.80 | Professional | None | $91.20 | $147.91 | $213.80 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $457.09 Median $588.84 Typical High $1,479.11 | Facility | None | $457.09 | $588.84 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $91.20 Median $151.36 Typical High $213.80 | Professional | None | $91.20 | $151.36 | $213.80 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $263.03 | Professional | None | $131.83 | $169.82 | $263.03 |
SummaCare Setting Facility Modifier None Typical Low $251.19 Median $263.03 Typical High $295.12 | Facility | None | $251.19 | $263.03 | $295.12 |
SummaCare Setting Professional Modifier None Typical Low $75.86 Median $134.90 Typical High $169.82 | Professional | None | $75.86 | $134.90 | $169.82 |
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 $67.61 Median $128.82 Typical High $245.47 | Professional | None | $67.61 | $128.82 | $245.47 |
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 $35.48 Median $58.88 Typical High $70.79 | Professional | 52 · Reduced service | $35.48 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $23.44 Typical High $28.84 | Professional | 53 · Discontinued | $14.13 | $23.44 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $89.13 Typical High $107.15 | Professional | 54 · Surgery only | $52.48 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $17.78 Typical High $21.38 | Professional | 55 · Aftercare only | $10.72 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $11.75 Typical High $14.45 | Professional | 56 · Pre-op care only | $7.08 | $11.75 | $14.45 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 59 · Distinct service | $72.44 | $72.44 | $72.44 |
Where Ohio sits
The same service costs 8.0 times more in New York than in North Dakota. 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 $2,762ND $346
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.