How much rates vary
Facilitymedian $3,090 · 10th to 90th $977 to $10,965Professionalmedian $955 · 10th to 90th $98 to $1,445
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 $1,737.80 Median $9,332.54 Typical High $13,182.57 | Facility | None | $1,737.80 | $9,332.54 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $977.24 Typical High $10,232.93 | Professional | None | $954.99 | $977.24 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $2,238.72 Typical High $7,943.28 | Facility | None | $933.25 | $2,238.72 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,659.59 | Professional | None | $851.14 | $1,000.00 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,513.56 Typical High $2,511.89 | Professional | 50 · Both sides | $1,258.93 | $1,513.56 | $2,511.89 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $2,818.38 Typical High $3,630.78 | Facility | None | $1,258.93 | $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 $870.96 Median $1,047.13 Typical High $2,089.30 | Professional | None | $870.96 | $1,047.13 | $2,089.30 |
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 $870.96 Median $1,047.13 Typical High $2,089.30 | Professional | None | $870.96 | $1,047.13 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $794.33 Typical High $1,230.27 | Professional | None | $83.18 | $794.33 | $1,230.27 |
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 $912.01 Median $912.01 Typical High $1,479.11 | Professional | None | $912.01 | $912.01 | $1,479.11 |
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 $891.25 Median $1,148.15 Typical High $2,290.87 | Professional | None | $891.25 | $1,148.15 | $2,290.87 |
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 $478.63 Median $478.63 Typical High $2,187.76 | Professional | 52 · Reduced service | $478.63 | $478.63 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $870.96 | Professional | 53 · Discontinued | $190.55 | $190.55 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $3,235.94 | Professional | 54 · Surgery only | $707.95 | $707.95 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $660.69 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $436.52 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $3,019.95 |
Where Ohio sits
The same service costs 3.6 times more in Alaska than in Montana. 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 $11,248MT $3,134
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.