How much rates vary
Facilitymedian $646 · 10th to 90th $316 to $3,548Professionalmedian $204 · 10th to 90th $95 to $398
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 $213.80 Median $776.25 Typical High $10,232.93 | Facility | None | $213.80 | $776.25 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $229.09 Typical High $691.83 | Professional | None | $114.82 | $229.09 | $691.83 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $954.99 Typical High $3,388.44 | Facility | None | $389.05 | $954.99 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $112.20 Typical High $177.83 | Professional | None | $91.20 | $112.20 | $177.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $134.90 Median $169.82 Typical High $269.15 | Professional | 50 · Both sides | $134.90 | $169.82 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $158.49 Median $457.09 Typical High $602.56 | Facility | None | $158.49 | $457.09 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $537.03 Typical High $1,479.11 | Facility | None | $363.08 | $537.03 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $251.19 Typical High $407.38 | Professional | None | $141.25 | $251.19 | $407.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $549.54 Typical High $1,479.11 | Facility | None | $389.05 | $549.54 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $141.25 Median $251.19 Typical High $407.38 | Professional | None | $141.25 | $251.19 | $407.38 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $416.87 | Professional | None | $204.17 | $269.15 | $416.87 |
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 $120.23 Median $229.09 Typical High $346.74 | Professional | None | $120.23 | $229.09 | $346.74 |
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 $89.13 Median $190.55 Typical High $416.87 | Professional | None | $89.13 | $190.55 | $416.87 |
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 $57.54 Median $114.82 Typical High $131.83 | Professional | 52 · Reduced service | $57.54 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $45.71 Typical High $52.48 | Professional | 53 · Discontinued | $22.91 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $173.78 Typical High $199.53 | Professional | 54 · Surgery only | $87.10 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $34.67 Typical High $39.81 | Professional | 55 · Aftercare only | $17.38 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $22.91 Typical High $26.30 | Professional | 56 · Pre-op care only | $11.48 | $22.91 | $26.30 |
Where Ohio sits
The same service costs 4.6 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 $2,775MT $606
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.