How much rates vary
Facilitymedian $331 · 10th to 90th $78 to $3,631Professionalmedian $120 · 10th to 90th $59 to $200
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 $74.13 Median $177.83 Typical High $10,964.78 | Facility | None | $74.13 | $177.83 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $97.72 Typical High $288.40 | Professional | None | $51.29 | $97.72 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $56.23 Median $87.10 Typical High $134.90 | Professional | None | $56.23 | $87.10 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $194.98 | Professional | None | $87.10 | $125.89 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $72.44 Median $537.03 Typical High $812.83 | Facility | None | $72.44 | $537.03 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $141.25 | Professional | None | $114.82 | $114.82 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $794.33 | Facility | None | $50.12 | $66.07 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $93.33 Typical High $199.53 | Professional | None | $52.48 | $93.33 | $199.53 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $223.87 Typical High $562.34 | Facility | None | $58.88 | $223.87 | $562.34 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $52.48 Median $93.33 Typical High $199.53 | Professional | None | $52.48 | $93.33 | $199.53 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $213.80 | Professional | None | $112.20 | $151.36 | $213.80 |
SummaCare Setting Professional Modifier None Typical Low $58.88 Median $112.20 Typical High $151.36 | Professional | None | $58.88 | $112.20 | $151.36 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $56.23 Median $104.71 Typical High $186.21 | Professional | None | $56.23 | $104.71 | $186.21 |
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 $25.70 Median $48.98 Typical High $51.29 | Professional | 52 · Reduced service | $25.70 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $19.50 Typical High $20.42 | Professional | 53 · Discontinued | $10.47 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $74.13 Typical High $77.62 | Professional | 54 · Surgery only | $38.90 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $14.79 Typical High $15.49 | Professional | 55 · Aftercare only | $7.76 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $9.77 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.25 | $9.77 | $10.23 |
Where Ohio sits
The same service costs 12.9 times more in Colorado than in Maine. 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 $2,408ME $187
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.