How much rates vary
Facilitymedian $1,995 · 10th to 90th $525 to $7,586Professionalmedian $661 · 10th to 90th $138 to $1,072
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 $363.08 Median $2,344.23 Typical High $10,715.19 | Facility | None | $363.08 | $2,344.23 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $794.33 Typical High $3,715.35 | Professional | None | $199.53 | $794.33 | $3,715.35 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $162.18 | Professional | None | $138.04 | $138.04 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,819.70 Typical High $7,585.78 | Facility | None | $588.84 | $1,819.70 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $562.34 Typical High $1,000.00 | Professional | None | $169.82 | $562.34 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $1,949.84 Typical High $2,511.89 | Facility | None | $223.87 | $1,949.84 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,187.76 Typical High $3,715.35 | Facility | None | $512.86 | $2,187.76 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $537.03 Typical High $1,148.15 | Professional | None | $186.21 | $537.03 | $1,148.15 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $2,137.96 Typical High $3,715.35 | Facility | None | $512.86 | $2,137.96 | $3,715.35 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $186.21 Median $575.44 Typical High $1,148.15 | Professional | None | $186.21 | $575.44 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $660.69 Typical High $912.01 | Professional | None | $67.61 | $660.69 | $912.01 |
SummaCare Setting Facility Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,258.93 | Facility | None | $1,071.52 | $1,122.02 | $1,258.93 |
SummaCare Setting Professional Modifier None Typical Low $169.82 Median $741.31 Typical High $1,047.13 | Professional | None | $169.82 | $741.31 | $1,047.13 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $213.80 Median $741.31 Typical High $1,445.44 | Professional | None | $213.80 | $741.31 | $1,445.44 |
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 $100.00 Median $398.11 Typical High $446.68 | Professional | 52 · Reduced service | $100.00 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $158.49 Typical High $181.97 | Professional | 53 · Discontinued | $39.81 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $602.56 Typical High $676.08 | Professional | 54 · Surgery only | $147.91 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $120.23 Typical High $134.90 | Professional | 55 · Aftercare only | $29.51 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $79.43 Typical High $91.20 | Professional | 56 · Pre-op care only | $19.95 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $562.34 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $138.04 | $562.34 | $630.96 |
Where Ohio sits
The same service costs 5.1 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 $7,315MT $1,443
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.