How much rates vary
Facilitymedian $631 · 10th to 90th $83 to $4,786Professionalmedian $224 · 10th to 90th $79 to $372
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 $933.25 Median $3,235.94 Typical High $12,589.25 | Facility | None | $933.25 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $1,023.29 | Professional | None | $223.87 | $251.19 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,148.15 Typical High $4,570.88 | Facility | None | $524.81 | $1,148.15 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $309.03 | Professional | None | $138.04 | $162.18 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $177.83 Typical High $281.84 | Facility | None | $138.04 | $177.83 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $154.88 Typical High $269.15 | Facility | None | $58.88 | $154.88 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $457.09 | Professional | None | $257.04 | $323.59 | $457.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $154.88 Typical High $263.03 | Facility | None | $58.88 | $154.88 | $263.03 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $446.68 | Professional | None | $257.04 | $323.59 | $446.68 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $169.82 Typical High $288.40 | Professional | None | $63.10 | $169.82 | $288.40 |
SummaCare Setting Facility Modifier None Typical Low $75.86 Median $79.43 Typical High $89.13 | Facility | None | $75.86 | $79.43 | $89.13 |
SummaCare Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $302.00 | Professional | None | $223.87 | $257.04 | $302.00 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,951.21 | Facility | None | $97.72 | $275.42 | $2,951.21 |
United Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $467.74 | Professional | None | $177.83 | $281.84 | $467.74 |
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 $112.20 Median $123.03 Typical High $147.91 | Professional | 52 · Reduced service | $112.20 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $50.12 Typical High $58.88 | Professional | 53 · Discontinued | $44.67 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $186.21 Typical High $223.87 | Professional | 54 · Surgery only | $165.96 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $37.15 Typical High $44.67 | Professional | 55 · Aftercare only | $33.88 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.12 Typical High $29.51 | Professional | 56 · Pre-op care only | $22.39 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $173.78 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $154.88 | $173.78 | $208.93 |
Where Ohio sits
The same service costs 10.5 times more in Colorado than in Florida. 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 $4,157FL $396
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.