How much rates vary
Facilitymedian $741 · 10th to 90th $372 to $4,169Professionalmedian $132 · 10th to 90th $79 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 $575.44 Median $3,235.94 Typical High $12,589.25 | Facility | None | $575.44 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $630.96 | Professional | None | $79.43 | $120.23 | $630.96 |
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 $75.86 Median $95.50 Typical High $141.25 | Professional | None | $75.86 | $95.50 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $457.09 Typical High $602.56 | Facility | None | $109.65 | $457.09 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $588.84 Typical High $1,995.26 | Facility | None | $457.09 | $588.84 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $213.80 | Professional | None | $100.00 | $147.91 | $213.80 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $457.09 Median $588.84 Typical High $1,995.26 | Facility | None | $457.09 | $588.84 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $213.80 | Professional | None | $100.00 | $147.91 | $213.80 |
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 $251.19 Median $263.03 Typical High $295.12 | Facility | None | $251.19 | $263.03 | $295.12 |
SummaCare Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $177.83 | Professional | None | $89.13 | $123.03 | $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 $70.79 Median $128.82 Typical High $229.09 | Professional | None | $70.79 | $128.82 | $229.09 |
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 $39.81 Median $60.26 Typical High $69.18 | Professional | 52 · Reduced service | $39.81 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $23.99 Typical High $27.54 | Professional | 53 · Discontinued | $15.85 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $91.20 Typical High $104.71 | Professional | 54 · Surgery only | $58.88 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $18.20 Typical High $20.89 | Professional | 55 · Aftercare only | $12.02 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $12.02 Typical High $13.80 | Professional | 56 · Pre-op care only | $7.94 | $12.02 | $13.80 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 59 · Distinct service | $120.23 | $120.23 | $120.23 |
Where Ohio sits
The same service costs 7.7 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 $2,820ND $368
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.