How much rates vary
Facilitymedian $1,349 · 10th to 90th $537 to $6,918Professionalmedian $355 · 10th to 90th $65 to $617
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 $467.74 Median $1,348.96 Typical High $10,715.19 | Facility | None | $467.74 | $1,348.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $1,348.96 | Professional | None | $251.19 | $354.81 | $1,348.96 |
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 $229.09 Median $323.59 Typical High $512.86 | Professional | None | $229.09 | $323.59 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $354.81 Median $1,174.90 Typical High $1,513.56 | Facility | None | $354.81 | $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 $245.47 Median $346.74 Typical High $660.69 | Professional | None | $245.47 | $346.74 | $660.69 |
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 $245.47 Median $346.74 Typical High $660.69 | Professional | None | $245.47 | $346.74 | $660.69 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $371.54 Typical High $575.44 | Professional | None | $32.36 | $371.54 | $575.44 |
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 $257.04 Median $398.11 Typical High $489.78 | Professional | None | $257.04 | $398.11 | $489.78 |
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 $245.47 Median $363.08 Typical High $660.69 | Professional | None | $245.47 | $363.08 | $660.69 |
7 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 $125.89 Median $173.78 Typical High $181.97 | Professional | 52 · Reduced service | $125.89 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $69.18 Typical High $72.44 | Professional | 53 · Discontinued | $50.12 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $263.03 Typical High $275.42 | Professional | 54 · Surgery only | $190.55 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $52.48 Typical High $54.95 | Professional | 55 · Aftercare only | $38.02 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $34.67 Typical High $36.31 | Professional | 56 · Pre-op care only | $25.12 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $245.47 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $177.83 | $245.47 | $257.04 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 51 · Multiple procedures | $125.89 | $125.89 | $125.89 |
Where Ohio sits
The same service costs 6.1 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 $6,346MT $1,043
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.