How much rates vary
Facilitymedian $912 · 10th to 90th $427 to $4,786Professionalmedian $269 · 10th to 90th $129 to $479
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 $239.88 Median $812.83 Typical High $10,232.93 | Facility | None | $239.88 | $812.83 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $831.76 | Professional | None | $128.82 | $245.47 | $831.76 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $141.25 | Professional | None | $53.70 | $70.79 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,148.15 Typical High $4,466.84 | Facility | None | $524.81 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $263.03 Typical High $407.38 | Professional | None | $138.04 | $263.03 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $162.18 Median $758.58 Typical High $1,000.00 | Facility | None | $162.18 | $758.58 | $1,000.00 |
CareSource Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $316.23 | Professional | None | $281.84 | $295.12 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $891.25 Typical High $1,995.26 | Facility | None | $512.86 | $891.25 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $245.47 Typical High $436.52 | Professional | None | $138.04 | $245.47 | $436.52 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $524.81 Median $933.25 Typical High $2,187.76 | Facility | None | $524.81 | $933.25 | $2,187.76 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $138.04 Median $245.47 Typical High $436.52 | Professional | None | $138.04 | $245.47 | $436.52 |
Molina Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $489.78 | Professional | None | $275.42 | $363.08 | $489.78 |
SummaCare Setting Facility Modifier None Typical Low $436.52 Median $457.09 Typical High $512.86 | Facility | None | $436.52 | $457.09 | $512.86 |
SummaCare Setting Professional Modifier None Typical Low $125.89 Median $275.42 Typical High $426.58 | Professional | None | $125.89 | $275.42 | $426.58 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $131.83 Median $251.19 Typical High $489.78 | Professional | None | $131.83 | $251.19 | $489.78 |
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 $64.57 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $64.57 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $26.30 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $181.97 Typical High $181.97 | Professional | 54 · Surgery only | $97.72 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $19.50 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.88 | $24.55 | $24.55 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $61.66 Median $66.07 Typical High $93.33 | Professional | 51 · Multiple procedures | $61.66 | $66.07 | $93.33 |
Where Ohio sits
The same service costs 8.2 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 $4,192WV $514
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.