How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,148 to $22,387Professionalmedian $1,230 · 10th to 90th $933 to $2,951
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 $3,890.45 Median $9,120.11 Typical High $12,589.25 | Facility | None | $3,890.45 | $9,120.11 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $3,090.30 Typical High $10,232.93 | Professional | None | $1,122.02 | $3,090.30 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $4,677.35 Typical High $21,877.62 | Facility | None | $1,479.11 | $4,677.35 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,862.09 | Professional | None | $977.24 | $1,230.27 | $1,862.09 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $20,417.38 Typical High $23,442.29 | Facility | None | $426.58 | $20,417.38 | $23,442.29 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,630.27 | Professional | None | $1,071.52 | $1,412.54 | $2,630.27 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $100.00 Median $446.68 Typical High $22,387.21 | Facility | None | $100.00 | $446.68 | $22,387.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,630.27 | Professional | None | $1,071.52 | $1,412.54 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,288.25 | Professional | None | $870.96 | $1,071.52 | $1,288.25 |
SummaCare Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,862.09 | Professional | None | $954.99 | $1,047.13 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $6,456.54 Typical High $23,442.29 | Facility | None | $1,258.93 | $6,456.54 | $23,442.29 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $2,754.23 | Professional | None | $1,096.48 | $1,584.89 | $2,754.23 |
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 $562.34 Median $562.34 Typical High $1,862.09 | Professional | 52 · Reduced service | $562.34 | $562.34 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $741.31 | Professional | 53 · Discontinued | $223.87 | $223.87 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $2,754.23 | Professional | 54 · Surgery only | $831.76 | $831.76 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $549.54 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $371.54 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $371.54 |
Where Ohio sits
The same service costs 8.1 times more in Indiana than in Kentucky. 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
IN $23,026KY $2,834
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.