How much rates vary
Facilitymedian $1,047 · 10th to 90th $513 to $5,129Professionalmedian $447 · 10th to 90th $81 to $708
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 $933.25 Median $3,311.31 Typical High $11,220.18 | Facility | None | $933.25 | $3,311.31 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $2,041.74 | Professional | None | $512.86 | $512.86 | $2,041.74 |
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 $354.81 Median $446.68 Typical High $707.95 | Professional | None | $354.81 | $446.68 | $707.95 |
Aultcare Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $616.60 | Professional | None | $575.44 | $575.44 | $616.60 |
CareSource Setting Facility Modifier None Typical Low $660.69 Median $691.83 Typical High $891.25 | Facility | None | $660.69 | $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 $524.81 Median $660.69 Typical High $954.99 | Professional | None | $524.81 | $660.69 | $954.99 |
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 $524.81 Median $660.69 Typical High $954.99 | Professional | None | $524.81 | $660.69 | $954.99 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $398.11 Typical High $630.96 | Professional | None | $67.61 | $398.11 | $630.96 |
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 $446.68 Median $501.19 Typical High $645.65 | Professional | None | $446.68 | $501.19 | $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 $331.13 Median $524.81 Typical High $933.25 | Professional | None | $331.13 | $524.81 | $933.25 |
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 $257.04 Median $257.04 Typical High $891.25 | Professional | 52 · Reduced service | $257.04 | $257.04 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $354.81 | Professional | 53 · Discontinued | $102.33 | $102.33 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $1,318.26 | Professional | 54 · Surgery only | $380.19 | $380.19 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $269.15 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $177.83 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $1,258.93 |
Where Ohio sits
The same service costs 4.0 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 $5,106MD $1,261
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.