How much rates vary
Facilitymedian $1,514 · 10th to 90th $575 to $7,413Professionalmedian $447 · 10th to 90th $87 to $759
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 $1,096.48 Median $2,691.53 Typical High $10,964.78 | Facility | None | $1,096.48 | $2,691.53 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $1,122.02 | Professional | None | $338.84 | $436.52 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,659.59 Typical High $7,585.78 | Facility | None | $562.34 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $645.65 | Professional | None | $316.23 | $389.05 | $645.65 |
CareSource Setting Facility Modifier None Typical Low $512.86 Median $1,174.90 Typical High $1,513.56 | Facility | None | $512.86 | $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 $407.38 Median $575.44 Typical High $851.14 | Professional | None | $407.38 | $575.44 | $851.14 |
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 $407.38 Median $575.44 Typical High $851.14 | Professional | None | $407.38 | $575.44 | $851.14 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $416.87 Typical High $741.31 | Professional | None | $70.79 | $416.87 | $741.31 |
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 $398.11 Median $512.86 Typical High $707.95 | Professional | None | $398.11 | $512.86 | $707.95 |
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 $302.00 Median $489.78 Typical High $870.96 | Professional | None | $302.00 | $489.78 | $870.96 |
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 $204.17 Median $281.84 Typical High $295.12 | Professional | 52 · Reduced service | $204.17 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $112.20 Typical High $117.49 | Professional | 53 · Discontinued | $81.28 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $416.87 Typical High $446.68 | Professional | 54 · Surgery only | $302.00 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $85.11 Typical High $89.13 | Professional | 55 · Aftercare only | $60.26 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $56.23 Typical High $58.88 | Professional | 56 · Pre-op care only | $40.74 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $389.05 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $281.84 | $389.05 | $416.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $588.84 Typical High $977.24 | Professional | 50 · Both sides | $467.74 | $588.84 | $977.24 |
Where Ohio sits
The same service costs 4.4 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 $6,491MT $1,489
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.