How much rates vary
Facilitymedian $1,585 · 10th to 90th $617 to $7,413Professionalmedian $661 · 10th to 90th $135 to $1,072
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 $1,778.28 Median $3,801.89 Typical High $10,964.78 | Facility | None | $1,778.28 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $2,511.89 | Professional | None | $645.65 | $776.25 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,148.15 Typical High $4,786.30 | Facility | None | $562.34 | $1,148.15 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $1,000.00 | Professional | None | $562.34 | $660.69 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,288.25 | Facility | None | $776.25 | $1,000.00 | $1,288.25 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,148.15 Typical High $2,398.83 | Facility | None | $602.56 | $1,148.15 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $1,148.15 | Professional | None | $537.03 | $776.25 | $1,148.15 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,148.15 Typical High $2,398.83 | Facility | None | $602.56 | $1,148.15 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $1,148.15 | Professional | None | $537.03 | $776.25 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $524.81 Typical High $933.25 | Professional | None | $69.18 | $524.81 | $933.25 |
SummaCare Setting Facility Modifier None Typical Low $562.34 Median $588.84 Typical High $660.69 | Facility | None | $562.34 | $588.84 | $660.69 |
SummaCare Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $912.01 | Professional | None | $562.34 | $776.25 | $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 $537.03 Median $707.95 Typical High $1,230.27 | Professional | None | $537.03 | $707.95 | $1,230.27 |
7 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 $323.59 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $323.59 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $128.82 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $489.78 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $97.72 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $64.57 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $457.09 | $537.03 | $537.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $977.24 Typical High $1,513.56 | Professional | 50 · Both sides | $831.76 | $977.24 | $1,513.56 |
Where Ohio sits
The same service costs 3.7 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 $6,098WV $1,627
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.