How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,023 to $10,965Professionalmedian $1,318 · 10th to 90th $100 to $1,995
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 $2,398.83 Median $8,317.64 Typical High $12,882.50 | Facility | None | $2,398.83 | $8,317.64 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $10,232.93 | Professional | None | $1,288.25 | $1,348.96 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $2,290.87 Typical High $7,943.28 | Facility | None | $933.25 | $2,290.87 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,318.26 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $1,995.26 Typical High $3,548.13 | Professional | 50 · Both sides | $1,698.24 | $1,995.26 | $3,548.13 |
CareSource Setting Facility Modifier None Typical Low $1,698.24 Median $2,818.38 Typical High $3,630.78 | Facility | None | $1,698.24 | $2,818.38 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $3,162.28 Typical High $5,248.07 | Facility | None | $1,071.52 | $3,162.28 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $2,818.38 | Professional | None | $1,230.27 | $1,380.38 | $2,818.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,096.48 Median $3,235.94 Typical High $5,248.07 | Facility | None | $1,096.48 | $3,235.94 | $5,248.07 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $2,818.38 | Professional | None | $1,230.27 | $1,380.38 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $1,122.02 Typical High $1,778.28 | Professional | None | $83.18 | $1,122.02 | $1,778.28 |
SummaCare Setting Facility Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,621.81 | $1,862.09 |
SummaCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,949.84 | Professional | None | $1,288.25 | $1,288.25 | $1,949.84 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $3,162.28 | Professional | None | $1,174.90 | $1,513.56 | $3,162.28 |
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 $645.65 Median $645.65 Typical High $2,511.89 | Professional | 52 · Reduced service | $645.65 | $645.65 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $1,000.00 | Professional | 53 · Discontinued | $257.04 | $257.04 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $3,715.35 | Professional | 54 · Surgery only | $954.99 | $954.99 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $758.58 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $501.19 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $3,467.37 |
Where Ohio sits
The same service costs 3.1 times more in Alaska than in Delaware. 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 $12,999DE $4,240
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.