How much rates vary
Facilitymedian $1,000 · 10th to 90th $457 to $5,012Professionalmedian $550 · 10th to 90th $89 to $912
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 $1,862.09 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,862.09 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $3,311.31 | Professional | None | $691.83 | $691.83 | $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 $512.86 Median $645.65 Typical High $1,047.13 | Professional | None | $512.86 | $645.65 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $954.99 Typical High $1,548.82 | Professional | 50 · Both sides | $776.25 | $954.99 | $1,548.82 |
CareSource Setting Facility Modifier None Typical Low $691.83 Median $870.96 Typical High $891.25 | Facility | None | $691.83 | $870.96 | $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 $707.95 Median $891.25 Typical High $1,258.93 | Professional | None | $707.95 | $891.25 | $1,258.93 |
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 $707.95 Median $891.25 Typical High $1,258.93 | Professional | None | $707.95 | $891.25 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $446.68 Typical High $794.33 | Professional | None | $70.79 | $446.68 | $794.33 |
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 $602.56 Median $660.69 Typical High $870.96 | Professional | None | $602.56 | $660.69 | $870.96 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,388.44 | Facility | None | $363.08 | $691.83 | $3,388.44 |
United Setting Professional Modifier None Typical Low $436.52 Median $724.44 Typical High $1,258.93 | Professional | None | $436.52 | $724.44 | $1,258.93 |
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 $346.74 Median $346.74 Typical High $1,000.00 | Professional | 52 · Reduced service | $346.74 | $346.74 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $398.11 | Professional | 53 · Discontinued | $138.04 | $138.04 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $1,513.56 | Professional | 54 · Surgery only | $512.86 | $512.86 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $302.00 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $199.53 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $1,412.54 |
Where Ohio sits
The same service costs 3.6 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 $4,868DE $1,354
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.