How much rates vary
Facilitymedian $1,380 · 10th to 90th $525 to $7,413Professionalmedian $219 · 10th to 90th $59 to $407
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 $426.58 Median $2,691.53 Typical High $10,964.78 | Facility | None | $426.58 | $2,691.53 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $812.83 | Professional | None | $154.88 | $223.87 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,584.89 Typical High $7,585.78 | Facility | None | $562.34 | $1,584.89 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $331.13 | Professional | None | $138.04 | $199.53 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $1,174.90 Typical High $1,513.56 | Facility | None | $218.78 | $1,174.90 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,318.26 Typical High $2,187.76 | Facility | None | $512.86 | $1,318.26 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $407.38 | Professional | None | $177.83 | $251.19 | $407.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,318.26 Typical High $2,187.76 | Facility | None | $512.86 | $1,318.26 | $2,187.76 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $407.38 | Professional | None | $177.83 | $251.19 | $407.38 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $245.47 Typical High $407.38 | Professional | None | $32.36 | $245.47 | $407.38 |
SummaCare Setting Facility Modifier None Typical Low $645.65 Median $676.08 Typical High $758.58 | Facility | None | $645.65 | $676.08 | $758.58 |
SummaCare Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $331.13 | Professional | None | $177.83 | $269.15 | $331.13 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $398.11 | Professional | None | $147.91 | $218.78 | $398.11 |
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 $77.62 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $77.62 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $30.90 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $169.82 Typical High $169.82 | Professional | 54 · Surgery only | $117.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $23.44 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $15.49 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $158.49 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $109.65 | $158.49 | $158.49 |
Where Ohio sits
The same service costs 9.3 times more in Colorado 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
CO $5,912MT $637
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.