How much rates vary
Facilitymedian $1,000 · 10th to 90th $126 to $10,965Professionalmedian $257 · 10th to 90th $95 to $513
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 $1,445.44 Median $8,511.38 Typical High $13,803.84 | Facility | None | $1,445.44 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $8,128.31 | Professional | None | $151.36 | $151.36 | $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 $194.98 Median $269.15 Typical High $512.86 | Professional | None | $194.98 | $269.15 | $512.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $275.42 Median $407.38 Typical High $758.58 | Professional | 50 · Both sides | $275.42 | $407.38 | $758.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $102.33 Median $169.82 Typical High $323.59 | Professional | 62 · Two surgeons | $102.33 | $169.82 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $147.91 Median $1,023.29 Typical High $1,548.82 | Facility | None | $147.91 | $1,023.29 | $1,548.82 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $309.03 Typical High $478.63 | Professional | None | $83.18 | $309.03 | $478.63 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $83.18 Median $309.03 Typical High $478.63 | Professional | None | $83.18 | $309.03 | $478.63 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $154.88 | Professional | None | $83.18 | $102.33 | $154.88 |
SummaCare Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $154.88 | Professional | None | $102.33 | $102.33 | $154.88 |
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 $239.88 Median $288.40 Typical High $446.68 | Professional | None | $239.88 | $288.40 | $446.68 |
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 $75.86 Median $75.86 Typical High $630.96 | Professional | 52 · Reduced service | $75.86 | $75.86 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $257.04 | Professional | 53 · Discontinued | $30.20 | $30.20 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $954.99 | Professional | 54 · Surgery only | $114.82 | $114.82 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $190.55 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $125.89 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $125.89 |
Where Ohio sits
The same service costs 12.8 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 $4,641MD $364
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.