How much rates vary
Facilitymedian $1,175 · 10th to 90th $200 to $4,786Professionalmedian $339 · 10th to 90th $48 to $575
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 $1,122.02 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,122.02 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $3,235.94 | Professional | None | $457.09 | $457.09 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,047.13 Typical High $4,570.88 | Facility | None | $524.81 | $1,047.13 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $602.56 | Professional | None | $288.40 | $338.84 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $501.19 Typical High $891.25 | Professional | 50 · Both sides | $426.58 | $501.19 | $891.25 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $1,174.90 Typical High $1,513.56 | Facility | None | $549.54 | $1,174.90 | $1,513.56 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,318.26 Typical High $1,995.26 | Facility | None | $398.11 | $1,318.26 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $676.08 | Professional | None | $338.84 | $446.68 | $676.08 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $398.11 Median $1,318.26 Typical High $1,905.46 | Facility | None | $398.11 | $1,318.26 | $1,905.46 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $676.08 | Professional | None | $338.84 | $446.68 | $676.08 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $275.42 Typical High $478.63 | Professional | None | $33.88 | $275.42 | $478.63 |
SummaCare Setting Facility Modifier None Typical Low $645.65 Median $676.08 Typical High $776.25 | Facility | None | $645.65 | $676.08 | $776.25 |
SummaCare Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $549.54 | Professional | None | $416.87 | $457.09 | $549.54 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,951.21 | Facility | None | $97.72 | $275.42 | $2,951.21 |
United Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $776.25 | Professional | None | $338.84 | $426.58 | $776.25 |
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 $229.09 Median $229.09 Typical High $501.19 | Professional | 52 · Reduced service | $229.09 | $229.09 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $199.53 | Professional | 53 · Discontinued | $91.20 | $91.20 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $741.31 | Professional | 54 · Surgery only | $346.74 | $346.74 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $147.91 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $100.00 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $691.83 |
Where Ohio sits
The same service costs 5.4 times more in Alaska than in West Virginia. 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
AK $4,660WV $864
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.