How much rates vary
Facilitymedian $4,266 · 10th to 90th $589 to $12,303Professionalmedian $195 · 10th to 90th $151 to $380
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 $457.09 Median $6,606.93 Typical High $12,589.25 | Facility | None | $457.09 | $6,606.93 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $8,912.51 | Professional | None | $177.83 | $309.03 | $8,912.51 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $218.78 Typical High $218.78 | Professional | None | $91.20 | $218.78 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $3,715.35 Typical High $19,054.61 | Facility | None | $1,023.29 | $3,715.35 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $302.00 | Professional | None | $144.54 | $169.82 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $4,265.80 Typical High $5,495.41 | Facility | None | $194.98 | $4,265.80 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $4,265.80 Typical High $7,244.36 | Facility | None | $549.54 | $4,265.80 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $407.38 | Professional | None | $151.36 | $199.53 | $407.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $4,265.80 Typical High $6,760.83 | Facility | None | $549.54 | $4,265.80 | $6,760.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $407.38 | Professional | None | $158.49 | $199.53 | $407.38 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $245.47 | Professional | None | $154.88 | $194.98 | $245.47 |
SummaCare Setting Facility Modifier None Typical Low $2,290.87 Median $2,398.83 Typical High $2,754.23 | Facility | None | $2,290.87 | $2,398.83 | $2,754.23 |
SummaCare Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $275.42 | Professional | None | $144.54 | $169.82 | $275.42 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $478.63 | Professional | None | $169.82 | $229.09 | $478.63 |
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 $89.13 Median $89.13 Typical High $295.12 | Professional | 52 · Reduced service | $89.13 | $89.13 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $117.49 | Professional | 53 · Discontinued | $35.48 | $35.48 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $446.68 | Professional | 54 · Surgery only | $131.83 | $131.83 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $89.13 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $58.88 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $58.88 |
Where Ohio sits
The same service costs 30.9 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 $14,683MT $475
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.