How much rates vary
Facilitymedian $1,778 · 10th to 90th $550 to $7,586Professionalmedian $275 · 10th to 90th $214 to $490
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 $3,311.31 Typical High $11,220.18 | Facility | None | $446.68 | $3,311.31 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $3,715.35 | Professional | None | $245.47 | $309.03 | $3,715.35 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
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 $213.80 Median $251.19 Typical High $446.68 | Professional | None | $213.80 | $251.19 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $1,548.82 Typical High $2,041.74 | Facility | None | $302.00 | $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 $229.09 Median $275.42 Typical High $537.03 | Professional | None | $229.09 | $275.42 | $537.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,778.28 Typical High $2,570.40 | Facility | None | $512.86 | $1,778.28 | $2,570.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $537.03 | Professional | None | $229.09 | $269.15 | $537.03 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $389.05 | Professional | None | $223.87 | $288.40 | $389.05 |
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 $218.78 Median $218.78 Typical High $363.08 | Professional | None | $218.78 | $218.78 | $363.08 |
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 $223.87 Median $281.84 Typical High $562.34 | Professional | None | $223.87 | $281.84 | $562.34 |
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 $123.03 Median $123.03 Typical High $676.08 | Professional | 52 · Reduced service | $123.03 | $123.03 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $269.15 | Professional | 53 · Discontinued | $48.98 | $48.98 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $1,000.00 | Professional | 54 · Surgery only | $181.97 | $181.97 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $199.53 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $134.90 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $134.90 |
Where Ohio sits
The same service costs 8.5 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 $6,252MT $735
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.