How much rates vary
Facilitymedian $1,820 · 10th to 90th $537 to $7,586Professionalmedian $166 · 10th to 90th $138 to $316
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 $446.68 Median $3,548.13 Typical High $12,022.64 | Facility | None | $446.68 | $3,548.13 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $4,365.16 | Professional | None | $158.49 | $158.49 | $4,365.16 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $7,585.78 | Facility | None | $588.84 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $275.42 | Professional | None | $138.04 | $165.96 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $1,548.82 Typical High $2,041.74 | Facility | None | $194.98 | $1,548.82 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,778.28 Typical High $2,570.40 | Facility | None | $489.78 | $1,778.28 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $177.83 Typical High $389.05 | Professional | None | $147.91 | $177.83 | $389.05 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,778.28 Typical High $2,511.89 | Facility | None | $512.86 | $1,778.28 | $2,511.89 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $389.05 | Professional | None | $147.91 | $173.78 | $389.05 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $223.87 | Professional | None | $128.82 | $165.96 | $223.87 |
SummaCare Setting Facility Modifier None Typical Low $870.96 Median $912.01 Typical High $1,047.13 | Facility | None | $870.96 | $912.01 | $1,047.13 |
SummaCare Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $229.09 | Professional | None | $141.25 | $141.25 | $229.09 |
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 $141.25 Median $181.97 Typical High $363.08 | Professional | None | $141.25 | $181.97 | $363.08 |
5 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 $79.43 Median $79.43 Typical High $346.74 | Professional | 52 · Reduced service | $79.43 | $79.43 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $138.04 | Professional | 53 · Discontinued | $31.62 | $31.62 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $512.86 | Professional | 54 · Surgery only | $120.23 | $120.23 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $104.71 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $69.18 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $69.18 |
Where Ohio sits
The same service costs 13.0 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 $6,260MT $480
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.