How much rates vary
Facilitymedian $1,479 · 10th to 90th $537 to $6,918Professionalmedian $447 · 10th to 90th $81 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 $1,445.44 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,445.44 | $3,548.13 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $2,454.71 | Professional | None | $524.81 | $524.81 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,584.89 Typical High $7,585.78 | Facility | None | $562.34 | $1,584.89 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $831.76 | Professional | None | $416.87 | $524.81 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $776.25 Typical High $1,258.93 | Professional | 50 · Both sides | $630.96 | $776.25 | $1,258.93 |
Aultcare Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $1,174.90 Typical High $1,513.56 | Facility | None | $676.08 | $1,174.90 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,318.26 Typical High $2,187.76 | Facility | None | $489.78 | $1,318.26 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,000.00 | Professional | None | $549.54 | $676.08 | $1,000.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,318.26 Typical High $2,187.76 | Facility | None | $512.86 | $1,318.26 | $2,187.76 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,000.00 | Professional | None | $549.54 | $676.08 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $354.81 Typical High $630.96 | Professional | None | $70.79 | $354.81 | $630.96 |
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 $478.63 Median $524.81 Typical High $691.83 | Professional | None | $478.63 | $524.81 | $691.83 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,786.30 | Facility | None | $501.19 | $977.24 | $4,786.30 |
United Setting Professional Modifier None Typical Low $338.84 Median $575.44 Typical High $977.24 | Professional | None | $338.84 | $575.44 | $977.24 |
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 $263.03 Median $263.03 Typical High $891.25 | Professional | 52 · Reduced service | $263.03 | $263.03 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $354.81 | Professional | 53 · Discontinued | $104.71 | $104.71 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $1,318.26 | Professional | 54 · Surgery only | $398.11 | $398.11 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $263.03 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $177.83 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $1,230.27 |
Where Ohio sits
The same service costs 4.6 times more in Colorado than in Delaware. 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 $6,382DE $1,376
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.