How much rates vary
Facilitymedian $1,413 · 10th to 90th $575 to $7,413Professionalmedian $417 · 10th to 90th $89 to $692
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 $1,047.13 Median $2,691.53 Typical High $10,964.78 | Facility | None | $1,047.13 | $2,691.53 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $1,071.52 | Professional | None | $316.23 | $436.52 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,584.89 Typical High $7,585.78 | Facility | None | $562.34 | $1,584.89 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $660.69 | Professional | None | $288.40 | $363.08 | $660.69 |
Aultcare Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $478.63 Median $1,174.90 Typical High $1,513.56 | Facility | None | $478.63 | $1,174.90 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,318.26 Typical High $2,187.76 | Facility | None | $489.78 | $1,318.26 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $794.33 | Professional | None | $389.05 | $524.81 | $794.33 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,318.26 Typical High $2,187.76 | Facility | None | $512.86 | $1,318.26 | $2,187.76 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $776.25 | Professional | None | $389.05 | $524.81 | $776.25 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $380.19 Typical High $645.65 | Professional | None | $69.18 | $380.19 | $645.65 |
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 $489.78 Typical High $630.96 | Professional | None | $371.54 | $489.78 | $630.96 |
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 $281.84 Median $467.74 Typical High $812.83 | Professional | None | $281.84 | $467.74 | $812.83 |
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 $190.55 Median $251.19 Typical High $269.15 | Professional | 52 · Reduced service | $190.55 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $100.00 Typical High $109.65 | Professional | 53 · Discontinued | $75.86 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $371.54 Typical High $407.38 | Professional | 54 · Surgery only | $281.84 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $74.13 Typical High $81.28 | Professional | 55 · Aftercare only | $56.23 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $50.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $38.02 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $346.74 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $263.03 | $346.74 | $380.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $537.03 Typical High $954.99 | Professional | 50 · Both sides | $436.52 | $537.03 | $954.99 |
Where Ohio sits
The same service costs 4.7 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 $6,464MT $1,390
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.