How much rates vary
Facilitymedian $1,000 · 10th to 90th $427 to $4,786Professionalmedian $479 · 10th to 90th $148 to $871
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 $245.47 Median $1,380.38 Typical High $10,232.93 | Facility | None | $245.47 | $1,380.38 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $416.87 Typical High $2,187.76 | Professional | None | $131.83 | $416.87 | $2,187.76 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $229.09 Typical High $251.19 | Professional | None | $117.49 | $229.09 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $457.09 Typical High $831.76 | Professional | None | $144.54 | $457.09 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $213.80 Median $676.08 Typical High $1,230.27 | Professional | 50 · Both sides | $213.80 | $676.08 | $1,230.27 |
CareSource Setting Facility Modifier None Typical Low $186.21 Median $691.83 Typical High $891.25 | Facility | None | $186.21 | $691.83 | $891.25 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $588.84 | Professional | None | $524.81 | $549.54 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $812.83 Typical High $2,398.83 | Facility | None | $549.54 | $812.83 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $467.74 Typical High $954.99 | Professional | None | $158.49 | $467.74 | $954.99 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $616.60 Median $1,258.93 Typical High $3,715.35 | Facility | None | $616.60 | $1,258.93 | $3,715.35 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $158.49 Median $467.74 Typical High $954.99 | Professional | None | $158.49 | $467.74 | $954.99 |
Molina Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $776.25 | Professional | None | $426.58 | $562.34 | $776.25 |
SummaCare Setting Facility Modifier None Typical Low $380.19 Median $398.11 Typical High $457.09 | Facility | None | $380.19 | $398.11 | $457.09 |
SummaCare Setting Professional Modifier None Typical Low $134.90 Median $467.74 Typical High $602.56 | Professional | None | $134.90 | $467.74 | $602.56 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $154.88 Median $467.74 Typical High $1,000.00 | Professional | None | $154.88 | $467.74 | $1,000.00 |
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 $66.07 Median $208.93 Typical High $234.42 | Professional | 52 · Reduced service | $66.07 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $83.18 Typical High $93.33 | Professional | 53 · Discontinued | $26.92 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $309.03 Typical High $346.74 | Professional | 54 · Surgery only | $100.00 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $61.66 Typical High $69.18 | Professional | 55 · Aftercare only | $19.95 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $41.69 Typical High $46.77 | Professional | 56 · Pre-op care only | $13.18 | $41.69 | $46.77 |
Where Ohio sits
The same service costs 4.5 times more in Colorado than in Maryland. 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 $4,866MD $1,088
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.