How much rates vary
Facilitymedian $1,622 · 10th to 90th $603 to $7,762Professionalmedian $355 · 10th to 90th $55 to $631
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 $575.44 Median $1,621.81 Typical High $10,964.78 | Facility | None | $575.44 | $1,621.81 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $1,071.52 | Professional | None | $275.42 | $380.19 | $1,071.52 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,737.80 Typical High $7,585.78 | Facility | None | $645.65 | $1,737.80 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $436.52 | Professional | None | $173.78 | $204.17 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $407.38 Median $1,513.56 Typical High $1,995.26 | Facility | None | $407.38 | $1,513.56 | $1,995.26 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $707.95 | Professional | None | $323.59 | $489.78 | $707.95 |
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 $147.91 Median $407.38 Typical High $676.08 | Professional | None | $147.91 | $407.38 | $676.08 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $323.59 Typical High $616.60 | Professional | None | $33.88 | $323.59 | $616.60 |
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 $316.23 Median $478.63 Typical High $645.65 | Professional | None | $316.23 | $478.63 | $645.65 |
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 $245.47 Median $389.05 Typical High $707.95 | Professional | None | $245.47 | $389.05 | $707.95 |
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 $158.49 Median $234.42 Typical High $251.19 | Professional | 52 · Reduced service | $158.49 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $93.33 Typical High $100.00 | Professional | 53 · Discontinued | $63.10 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $346.74 Typical High $371.54 | Professional | 54 · Surgery only | $239.88 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $69.18 Typical High $74.13 | Professional | 55 · Aftercare only | $47.86 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $46.77 Typical High $50.12 | Professional | 56 · Pre-op care only | $31.62 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $323.59 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $223.87 | $323.59 | $346.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $109.65 Median $128.82 Typical High $269.15 | Professional | 62 · Two surgeons | $109.65 | $128.82 | $269.15 |
Where Ohio sits
The same service costs 6.4 times more in Colorado than in West Virginia. 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 $6,390WV $1,003
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.