How much rates vary
Facilitymedian $1,122 · 10th to 90th $537 to $5,248Professionalmedian $234 · 10th to 90th $151 to $347
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 $1,479.11 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,479.11 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $3,311.31 | Professional | None | $234.42 | $234.42 | $3,311.31 |
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 $134.90 Median $194.98 Typical High $309.03 | Professional | None | $134.90 | $194.98 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $724.44 Typical High $1,096.48 | Facility | None | $302.00 | $724.44 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $933.25 Typical High $2,398.83 | Facility | None | $537.03 | $933.25 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $398.11 | Professional | None | $234.42 | $309.03 | $398.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $933.25 Typical High $2,398.83 | Facility | None | $549.54 | $933.25 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $389.05 | Professional | None | $245.47 | $309.03 | $389.05 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $309.03 | Professional | None | $165.96 | $213.80 | $309.03 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,071.52 | Facility | None | $891.25 | $933.25 | $1,071.52 |
SummaCare Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $288.40 | Professional | None | $199.53 | $223.87 | $288.40 |
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 $151.36 Median $251.19 Typical High $426.58 | Professional | None | $151.36 | $251.19 | $426.58 |
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 $117.49 Median $117.49 Typical High $602.56 | Professional | 52 · Reduced service | $117.49 | $117.49 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $239.88 | Professional | 53 · Discontinued | $46.77 | $46.77 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $912.01 | Professional | 54 · Surgery only | $177.83 | $177.83 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $181.97 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $120.23 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $120.23 |
Where Ohio sits
The same service costs 6.2 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 $4,689MT $752
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.