How much rates vary
Facilitymedian $912 · 10th to 90th $129 to $10,715Professionalmedian $295 · 10th to 90th $135 to $603
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 $676.08 Median $6,606.93 Typical High $12,589.25 | Facility | None | $676.08 | $6,606.93 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $8,128.31 | Professional | None | $204.17 | $204.17 | $8,128.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,513.56 Typical High $16,595.87 | Facility | None | $588.84 | $1,513.56 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $630.96 | Professional | None | $218.78 | $302.00 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $446.68 Typical High $933.25 | Professional | 50 · Both sides | $323.59 | $446.68 | $933.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $134.90 Median $190.55 Typical High $398.11 | Professional | 62 · Two surgeons | $134.90 | $190.55 | $398.11 |
Aultcare Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $245.47 Median $1,023.29 Typical High $1,548.82 | Facility | None | $245.47 | $1,023.29 | $1,548.82 |
CareSource Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $851.14 Typical High $2,691.53 | Facility | None | $616.60 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $338.84 Typical High $524.81 | Professional | None | $134.90 | $338.84 | $524.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $851.14 Typical High $2,691.53 | Facility | None | $602.56 | $851.14 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $134.90 Median $338.84 Typical High $524.81 | Professional | None | $134.90 | $338.84 | $524.81 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $218.78 | Professional | None | $112.20 | $138.04 | $218.78 |
SummaCare Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $251.19 | Professional | None | $165.96 | $165.96 | $251.19 |
United Setting Facility Modifier None Typical Low $97.72 Median $257.04 Typical High $2,398.83 | Facility | None | $97.72 | $257.04 | $2,398.83 |
United Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $537.03 | Professional | None | $269.15 | $331.13 | $537.03 |
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 $102.33 Median $102.33 Typical High $954.99 | Professional | 52 · Reduced service | $102.33 | $102.33 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $380.19 | Professional | 53 · Discontinued | $40.74 | $40.74 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $1,412.54 | Professional | 54 · Surgery only | $151.36 | $151.36 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $281.84 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $190.55 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $190.55 |
Where Ohio sits
The same service costs 10.8 times more in New York than in Maryland. 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 $4,667MD $433
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.