How much rates vary
Facilitymedian $1,549 · 10th to 90th $646 to $7,943Professionalmedian $372 · 10th to 90th $79 to $589
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 $758.58 Median $4,168.69 Typical High $11,220.18 | Facility | None | $758.58 | $4,168.69 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $416.87 Typical High $1,659.59 | Professional | None | $407.38 | $416.87 | $1,659.59 |
Ambetter Setting Professional Modifier None Typical Low $275.42 Median $616.60 Typical High $616.60 | Professional | None | $275.42 | $616.60 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $1,548.82 Typical High $7,585.78 | Facility | None | $616.60 | $1,548.82 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $645.65 | Professional | None | $323.59 | $407.38 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $616.60 Typical High $977.24 | Professional | 50 · Both sides | $489.78 | $616.60 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $524.81 Median $1,174.90 Typical High $1,513.56 | Facility | None | $524.81 | $1,174.90 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,412.54 Typical High $6,025.60 | Facility | None | $602.56 | $1,412.54 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $776.25 | Professional | None | $426.58 | $524.81 | $776.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,479.11 Typical High $6,025.60 | Facility | None | $602.56 | $1,479.11 | $6,025.60 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $776.25 | Professional | None | $426.58 | $524.81 | $776.25 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $316.23 Typical High $501.19 | Professional | None | $67.61 | $316.23 | $501.19 |
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 $371.54 Median $416.87 Typical High $537.03 | Professional | None | $371.54 | $416.87 | $537.03 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $263.03 Median $446.68 Typical High $776.25 | Professional | None | $263.03 | $446.68 | $776.25 |
4 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 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $954.99 | Professional | 54 · Surgery only | $309.03 | $309.03 | $954.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $64.57 Typical High $104.71 | Professional | 80 · Assistant surgeon | $52.48 | $64.57 | $104.71 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $45.71 Median $57.54 Typical High $91.20 | Professional | AS · PA/NP assist | $45.71 | $57.54 | $91.20 |
Where Ohio sits
The same service costs 4.9 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 $6,755MT $1,384
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.