How much rates vary
Facilitymedian $1,445 · 10th to 90th $631 to $7,762Professionalmedian $490 · 10th to 90th $126 to $891
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 $660.69 Median $1,584.89 Typical High $10,715.19 | Facility | None | $660.69 | $1,584.89 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $1,905.46 | Professional | None | $389.05 | $537.03 | $1,905.46 |
Ambetter Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $660.69 | Professional | None | $512.86 | $512.86 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $1,698.24 Typical High $7,585.78 | Facility | None | $616.60 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $741.31 | Professional | None | $331.13 | $457.09 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $1,174.90 Typical High $1,513.56 | Facility | None | $549.54 | $1,174.90 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $2,398.83 | Facility | None | $602.56 | $1,318.26 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $977.24 | Professional | None | $436.52 | $588.84 | $977.24 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $2,398.83 | Facility | None | $602.56 | $1,318.26 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $977.24 | Professional | None | $436.52 | $616.60 | $977.24 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $501.19 Typical High $851.14 | Professional | None | $77.62 | $501.19 | $851.14 |
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 $446.68 Median $691.83 Typical High $891.25 | Professional | None | $446.68 | $691.83 | $891.25 |
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 $363.08 Median $537.03 Typical High $1,000.00 | Professional | None | $363.08 | $537.03 | $1,000.00 |
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 $194.98 Median $269.15 Typical High $275.42 | Professional | 52 · Reduced service | $194.98 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $107.15 Typical High $109.65 | Professional | 53 · Discontinued | $79.43 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $407.38 Typical High $416.87 | Professional | 54 · Surgery only | $295.12 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $81.28 Typical High $83.18 | Professional | 55 · Aftercare only | $58.88 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $53.70 Typical High $54.95 | Professional | 56 · Pre-op care only | $38.90 | $53.70 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $380.19 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $275.42 | $380.19 | $389.05 |
Where Ohio sits
The same service costs 5.2 times more in Colorado than in West Virginia. 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 $6,580WV $1,277
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.