How much rates vary
Facilitymedian $1,023 · 10th to 90th $302 to $4,266Professionalmedian $229 · 10th to 90th $91 to $389
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 $158.49 Median $676.08 Typical High $10,232.93 | Facility | None | $158.49 | $676.08 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $229.09 Typical High $1,862.09 | Professional | None | $93.33 | $229.09 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $75.86 Typical High $134.90 | Professional | None | $45.71 | $75.86 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $1,148.15 Typical High $4,466.84 | Facility | None | $467.74 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $218.78 Typical High $346.74 | Professional | None | $102.33 | $218.78 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $102.33 Median $1,548.82 Typical High $1,995.26 | Facility | None | $102.33 | $1,548.82 | $1,995.26 |
CareSource Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $257.04 | Professional | None | $229.09 | $239.88 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,698.24 Typical High $2,884.03 | Facility | None | $389.05 | $1,698.24 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $204.17 Typical High $354.81 | Professional | None | $87.10 | $204.17 | $354.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $1,698.24 Typical High $2,884.03 | Facility | None | $389.05 | $1,698.24 | $2,884.03 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $87.10 Median $213.80 Typical High $346.74 | Professional | None | $87.10 | $213.80 | $346.74 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $263.03 Typical High $338.84 | Professional | None | $213.80 | $263.03 | $338.84 |
SummaCare Setting Facility Modifier None Typical Low $831.76 Median $870.96 Typical High $1,000.00 | Facility | None | $831.76 | $870.96 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $79.43 Median $234.42 Typical High $354.81 | Professional | None | $79.43 | $234.42 | $354.81 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,388.44 | Facility | None | $363.08 | $691.83 | $3,388.44 |
United Setting Professional Modifier None Typical Low $107.15 Median $218.78 Typical High $426.58 | Professional | None | $107.15 | $218.78 | $426.58 |
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 $46.77 Median $112.20 Typical High $141.25 | Professional | 52 · Reduced service | $46.77 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $45.71 Typical High $56.23 | Professional | 53 · Discontinued | $18.62 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $169.82 Typical High $208.93 | Professional | 54 · Surgery only | $69.18 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $33.88 Typical High $42.66 | Professional | 55 · Aftercare only | $13.80 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $22.91 Typical High $28.18 | Professional | 56 · Pre-op care only | $9.33 | $22.91 | $28.18 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $70.79 Median $107.15 Typical High $186.21 | Professional | GC · Resident with teaching physician | $70.79 | $107.15 | $186.21 |
Where Ohio sits
The same service costs 10.4 times more in Colorado than in North Dakota. 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 $4,594ND $443
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.