How much rates vary
Facilitymedian $1,445 · 10th to 90th $562 to $7,413Professionalmedian $417 · 10th to 90th $91 to $724
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 $794.33 Median $2,691.53 Typical High $10,964.78 | Facility | None | $794.33 | $2,691.53 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $2,691.53 | Professional | None | $288.40 | $446.68 | $2,691.53 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,659.59 Typical High $7,585.78 | Facility | None | $562.34 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $602.56 | Professional | None | $223.87 | $363.08 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $537.03 Typical High $912.01 | Professional | 50 · Both sides | $346.74 | $537.03 | $912.01 |
CareSource Setting Facility Modifier None Typical Low $407.38 Median $1,174.90 Typical High $1,513.56 | Facility | None | $407.38 | $1,174.90 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,318.26 Typical High $2,187.76 | Facility | None | $489.78 | $1,318.26 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $758.58 | Professional | None | $323.59 | $489.78 | $758.58 |
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 $323.59 Median $489.78 Typical High $758.58 | Professional | None | $323.59 | $489.78 | $758.58 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $416.87 Typical High $707.95 | Professional | None | $37.15 | $416.87 | $707.95 |
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 $323.59 Median $489.78 Typical High $660.69 | Professional | None | $323.59 | $489.78 | $660.69 |
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 $269.15 Median $426.58 Typical High $794.33 | Professional | None | $269.15 | $426.58 | $794.33 |
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 $144.54 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $144.54 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $57.54 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $218.78 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $43.65 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $28.84 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $204.17 | $316.23 | $316.23 |
Where Ohio sits
The same service costs 5.3 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 $6,438MT $1,226
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.