How much rates vary
Facilitymedian $1,585 · 10th to 90th $589 to $7,762Professionalmedian $275 · 10th to 90th $51 to $513
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 $467.74 Median $1,348.96 Typical High $10,964.78 | Facility | None | $467.74 | $1,348.96 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $549.54 | Professional | None | $223.87 | $309.03 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,548.82 Typical High $7,585.78 | Facility | None | $602.56 | $1,548.82 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $346.74 | Professional | None | $134.90 | $162.18 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $323.59 Median $1,513.56 Typical High $1,995.26 | Facility | None | $323.59 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,737.80 Typical High $2,691.53 | Facility | None | $562.34 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $588.84 | Professional | None | $263.03 | $407.38 | $588.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,691.53 | Facility | None | $602.56 | $1,737.80 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $575.44 | Professional | None | $263.03 | $407.38 | $575.44 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $251.19 Typical High $457.09 | Professional | None | $33.88 | $251.19 | $457.09 |
SummaCare Setting Facility Modifier None Typical Low $851.14 Median $891.25 Typical High $1,000.00 | Facility | None | $851.14 | $891.25 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $457.09 | Professional | None | $251.19 | $331.13 | $457.09 |
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 $194.98 Median $323.59 Typical High $602.56 | Professional | None | $194.98 | $323.59 | $602.56 |
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 $128.82 Median $190.55 Typical High $204.17 | Professional | 52 · Reduced service | $128.82 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $75.86 Typical High $81.28 | Professional | 53 · Discontinued | $51.29 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $288.40 Typical High $309.03 | Professional | 54 · Surgery only | $190.55 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $57.54 Typical High $61.66 | Professional | 55 · Aftercare only | $38.02 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $38.02 Typical High $40.74 | Professional | 56 · Pre-op care only | $25.70 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $269.15 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $177.83 | $269.15 | $288.40 |
Where Ohio sits
The same service costs 6.3 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 $6,296MT $1,002
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.