How much rates vary
Facilitymedian $1,072 · 10th to 90th $513 to $5,248Professionalmedian $110 · 10th to 90th $83 to $162
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 $199.53 Median $3,715.35 Typical High $12,022.64 | Facility | None | $199.53 | $3,715.35 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $436.52 | Professional | None | $114.82 | $114.82 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $177.83 | Professional | None | $117.49 | $177.83 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $141.25 | Professional | None | $75.86 | $89.13 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $128.82 Median $851.14 Typical High $1,096.48 | Facility | None | $128.82 | $851.14 | $1,096.48 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | None | $109.65 | $109.65 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $912.01 Typical High $2,398.83 | Facility | None | $537.03 | $912.01 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $169.82 | Professional | None | $95.50 | $112.20 | $169.82 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $562.34 Median $933.25 Typical High $2,398.83 | Facility | None | $562.34 | $933.25 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $173.78 | Professional | None | $97.72 | $112.20 | $173.78 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $162.18 | Professional | None | $83.18 | $104.71 | $162.18 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,047.13 | Facility | None | $891.25 | $933.25 | $1,047.13 |
SummaCare Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $104.71 | Professional | None | $89.13 | $89.13 | $104.71 |
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 $87.10 Median $112.20 Typical High $173.78 | Professional | None | $87.10 | $112.20 | $173.78 |
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 $57.54 Median $57.54 Typical High $74.13 | Professional | 52 · Reduced service | $57.54 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $29.51 | Professional | 53 · Discontinued | $22.91 | $22.91 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $109.65 | Professional | 54 · Surgery only | $87.10 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $21.88 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $14.79 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $14.79 |
Where Ohio sits
The same service costs 14.5 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 $4,506MT $310
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.