How much rates vary
Facilitymedian $1,072 · 10th to 90th $490 to $5,248Professionalmedian $182 · 10th to 90th $141 to $339
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 $1,412.54 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,412.54 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $4,786.30 | Professional | None | $165.96 | $165.96 | $4,786.30 |
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 $147.91 Median $186.21 Typical High $331.13 | Professional | None | $147.91 | $186.21 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $204.17 Median $758.58 Typical High $1,000.00 | Facility | None | $204.17 | $758.58 | $1,000.00 |
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 $165.96 Median $194.98 Typical High $389.05 | Professional | None | $165.96 | $194.98 | $389.05 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $389.05 | Professional | None | $165.96 | $194.98 | $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 $436.52 Median $457.09 Typical High $512.86 | Facility | None | $436.52 | $457.09 | $512.86 |
SummaCare Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $245.47 | Professional | None | $158.49 | $158.49 | $245.47 |
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 $154.88 Median $194.98 Typical High $398.11 | Professional | None | $154.88 | $194.98 | $398.11 |
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 $83.18 Median $83.18 Typical High $346.74 | Professional | 52 · Reduced service | $83.18 | $83.18 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $138.04 | Professional | 53 · Discontinued | $33.11 | $33.11 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $512.86 | Professional | 54 · Surgery only | $123.03 | $123.03 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $102.33 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $69.18 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $69.18 |
Where Ohio sits
The same service costs 9.2 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 $4,822MT $526
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.