How much rates vary
Facilitymedian $1,096 · 10th to 90th $490 to $5,248Professionalmedian $275 · 10th to 90th $79 to $457
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 $1,412.54 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,412.54 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $3,311.31 | Professional | None | $316.23 | $316.23 | $3,311.31 |
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 $218.78 Median $269.15 Typical High $446.68 | Professional | None | $218.78 | $269.15 | $446.68 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $407.38 Typical High $660.69 | Professional | 50 · Both sides | $323.59 | $407.38 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,047.13 | Facility | None | $407.38 | $812.83 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $933.25 Typical High $1,995.26 | Facility | None | $489.78 | $933.25 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $575.44 | Professional | None | $316.23 | $398.11 | $575.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $933.25 Typical High $1,995.26 | Facility | None | $512.86 | $933.25 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $575.44 | Professional | None | $316.23 | $398.11 | $575.44 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $251.19 Typical High $407.38 | Professional | None | $67.61 | $251.19 | $407.38 |
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 $281.84 Median $316.23 Typical High $407.38 | Professional | None | $281.84 | $316.23 | $407.38 |
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 $199.53 Median $316.23 Typical High $575.44 | Professional | None | $199.53 | $316.23 | $575.44 |
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 $158.49 Typical High $630.96 | Professional | 52 · Reduced service | $158.49 | $158.49 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $251.19 | Professional | 53 · Discontinued | $63.10 | $63.10 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $933.25 | Professional | 54 · Surgery only | $234.42 | $234.42 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $186.21 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $125.89 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $223.87 | $223.87 | $870.96 |
Where Ohio sits
The same service costs 4.6 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 $4,822MT $1,050
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.