How much rates vary
Facilitymedian $1,000 · 10th to 90th $204 to $4,365Professionalmedian $417 · 10th to 90th $51 to $661
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 $1,122.02 Median $1,995.26 Typical High $10,964.78 | Facility | None | $1,122.02 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $1,412.54 | Professional | None | $416.87 | $457.09 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $457.09 Median $1,148.15 Typical High $4,466.84 | Facility | None | $457.09 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $575.44 | Professional | None | $269.15 | $338.84 | $575.44 |
CareSource Setting Facility Modifier None Typical Low $537.03 Median $812.83 Typical High $1,047.13 | Facility | None | $537.03 | $812.83 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $933.25 Typical High $1,584.89 | Facility | None | $363.08 | $933.25 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $758.58 | Professional | None | $416.87 | $524.81 | $758.58 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $933.25 Typical High $1,584.89 | Facility | None | $389.05 | $933.25 | $1,584.89 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $758.58 | Professional | None | $416.87 | $524.81 | $758.58 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $354.81 Typical High $616.60 | Professional | None | $33.88 | $354.81 | $616.60 |
SummaCare Setting Facility Modifier None Typical Low $446.68 Median $467.74 Typical High $537.03 | Facility | None | $446.68 | $467.74 | $537.03 |
SummaCare Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $602.56 | Professional | None | $426.58 | $512.86 | $602.56 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,951.21 | Facility | None | $97.72 | $275.42 | $2,951.21 |
United Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $758.58 | Professional | None | $281.84 | $426.58 | $758.58 |
7 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 $208.93 Median $229.09 Typical High $245.47 | Professional | 52 · Reduced service | $208.93 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $91.20 Typical High $97.72 | Professional | 53 · Discontinued | $83.18 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $346.74 Typical High $371.54 | Professional | 54 · Surgery only | $316.23 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $69.18 Typical High $74.13 | Professional | 55 · Aftercare only | $63.10 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $45.71 Typical High $48.98 | Professional | 56 · Pre-op care only | $41.69 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $323.59 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $295.12 | $323.59 | $346.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $501.19 Typical High $851.14 | Professional | 50 · Both sides | $407.38 | $501.19 | $851.14 |
Where Ohio sits
The same service costs 5.3 times more in Colorado than in Florida. 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 $4,377FL $831
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.