How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,000 to $10,965Professionalmedian $933 · 10th to 90th $93 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 $1,698.24 Median $8,317.64 Typical High $12,589.25 | Facility | None | $1,698.24 | $8,317.64 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $10,232.93 | Professional | None | $912.01 | $912.01 | $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 $831.76 Median $1,000.00 Typical High $1,737.80 | Professional | None | $831.76 | $1,000.00 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,513.56 Typical High $2,630.27 | Professional | 50 · Both sides | $1,258.93 | $1,513.56 | $2,630.27 |
CareSource Setting Facility Modifier None Typical Low $1,202.26 Median $2,818.38 Typical High $3,630.78 | Facility | None | $1,202.26 | $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 $851.14 Median $1,023.29 Typical High $2,041.74 | Professional | None | $851.14 | $1,023.29 | $2,041.74 |
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 $851.14 Median $1,023.29 Typical High $2,041.74 | Professional | None | $851.14 | $1,023.29 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $794.33 Typical High $1,230.27 | Professional | None | $81.28 | $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 $891.25 Median $891.25 Typical High $1,412.54 | Professional | None | $891.25 | $891.25 | $1,412.54 |
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 $870.96 Median $1,122.02 Typical High $2,238.72 | Professional | None | $870.96 | $1,122.02 | $2,238.72 |
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 $457.09 Median $457.09 Typical High $2,137.96 | Professional | 52 · Reduced service | $457.09 | $457.09 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $851.14 | Professional | 53 · Discontinued | $181.97 | $181.97 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $3,162.28 | Professional | 54 · Surgery only | $691.83 | $691.83 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $645.65 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $426.58 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $2,951.21 |
Where Ohio sits
The same service costs 3.7 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 $11,153MT $2,993
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.