How much rates vary
Facilitymedian $1,000 · 10th to 90th $501 to $4,786Professionalmedian $417 · 10th to 90th $46 to $724
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 $588.84 Median $1,659.59 Typical High $10,715.19 | Facility | None | $588.84 | $1,659.59 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $1,288.25 | Professional | None | $323.59 | $489.78 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,148.15 Typical High $4,466.84 | Facility | None | $524.81 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $162.18 Typical High $398.11 | Professional | None | $131.83 | $162.18 | $398.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $245.47 Typical High $602.56 | Professional | 50 · Both sides | $194.98 | $245.47 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $407.38 Median $691.83 Typical High $891.25 | Facility | None | $407.38 | $691.83 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $794.33 Typical High $1,995.26 | Facility | None | $489.78 | $794.33 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $741.31 | Professional | None | $331.13 | $489.78 | $741.31 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $794.33 Typical High $1,995.26 | Facility | None | $512.86 | $794.33 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $741.31 | Professional | None | $331.13 | $489.78 | $741.31 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $467.74 Typical High $741.31 | Professional | None | $32.36 | $467.74 | $741.31 |
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 $323.59 Median $446.68 Typical High $645.65 | Professional | None | $323.59 | $446.68 | $645.65 |
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 $194.98 Median $309.03 Typical High $724.44 | Professional | None | $194.98 | $309.03 | $724.44 |
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 $158.49 Median $245.47 Typical High $257.04 | Professional | 52 · Reduced service | $158.49 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $97.72 Typical High $102.33 | Professional | 53 · Discontinued | $64.57 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $363.08 Typical High $389.05 | Professional | 54 · Surgery only | $239.88 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $72.44 Typical High $77.62 | Professional | 55 · Aftercare only | $47.86 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $48.98 Typical High $51.29 | Professional | 56 · Pre-op care only | $32.36 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $338.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $223.87 | $338.84 | $363.08 |
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.