How much rates vary
Facilitymedian $1,479 · 10th to 90th $676 to $8,511Professionalmedian $562 · 10th to 90th $95 to $871
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 $2,344.23 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,344.23 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $8,912.51 | Professional | None | $707.95 | $707.95 | $8,912.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,174.90 Typical High $4,786.30 | Facility | None | $630.96 | $1,174.90 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $977.24 | Professional | None | $524.81 | $616.60 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $912.01 Typical High $1,445.44 | Professional | 50 · Both sides | $776.25 | $912.01 | $1,445.44 |
CareSource Setting Facility Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,513.56 | Facility | None | $851.14 | $1,174.90 | $1,513.56 |
CareSource Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,348.96 Typical High $2,951.21 | Facility | None | $741.31 | $1,348.96 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $1,122.02 | Professional | None | $489.78 | $741.31 | $1,122.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $1,348.96 Typical High $2,951.21 | Facility | None | $741.31 | $1,348.96 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $1,122.02 | Professional | None | $489.78 | $741.31 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $407.38 Typical High $707.95 | Professional | None | $69.18 | $407.38 | $707.95 |
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 $602.56 Median $602.56 Typical High $912.01 | Professional | None | $602.56 | $602.56 | $912.01 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $5,888.44 | Facility | None | $691.83 | $1,445.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $1,288.25 | Professional | None | $588.84 | $707.95 | $1,288.25 |
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 $354.81 Median $354.81 Typical High $1,096.48 | Professional | 52 · Reduced service | $354.81 | $354.81 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $446.68 | Professional | 53 · Discontinued | $141.25 | $141.25 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $1,659.59 | Professional | 54 · Surgery only | $524.81 | $524.81 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $331.13 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $218.78 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $1,548.82 |
Where Ohio sits
The same service costs 4.0 times more in Alaska than in Alabama. 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 $6,054AL $1,518
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.