How much rates vary
Facilitymedian $1,318 · 10th to 90th $427 to $9,120Professionalmedian $589 · 10th to 90th $182 to $1,023
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 $977.24 Median $8,128.31 Typical High $13,803.84 | Facility | None | $977.24 | $8,128.31 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $616.60 Typical High $8,128.31 | Professional | None | $194.98 | $616.60 | $8,128.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $501.19 Typical High $891.25 | Professional | None | $165.96 | $501.19 | $891.25 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $407.38 Typical High $524.81 | Facility | None | $218.78 | $407.38 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $512.86 Typical High $1,479.11 | Facility | None | $389.05 | $512.86 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $537.03 Typical High $891.25 | Professional | None | $186.21 | $537.03 | $891.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $512.86 Typical High $1,479.11 | Facility | None | $389.05 | $512.86 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $186.21 Median $537.03 Typical High $891.25 | Professional | None | $186.21 | $537.03 | $891.25 |
Molina Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $812.83 | Professional | None | $512.86 | $645.65 | $812.83 |
SummaCare Setting Facility Modifier None Typical Low $234.42 Median $245.47 Typical High $275.42 | Facility | None | $234.42 | $245.47 | $275.42 |
SummaCare Setting Professional Modifier None Typical Low $162.18 Median $562.34 Typical High $794.33 | Professional | None | $162.18 | $562.34 | $794.33 |
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 $204.17 Median $588.84 Typical High $1,148.15 | Professional | None | $204.17 | $588.84 | $1,148.15 |
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 $97.72 Median $309.03 Typical High $389.05 | Professional | 52 · Reduced service | $97.72 | $309.03 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $123.03 Typical High $154.88 | Professional | 53 · Discontinued | $39.81 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $467.74 Typical High $588.84 | Professional | 54 · Surgery only | $147.91 | $467.74 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $93.33 Typical High $117.49 | Professional | 55 · Aftercare only | $29.51 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $61.66 Typical High $77.62 | Professional | 56 · Pre-op care only | $19.50 | $61.66 | $77.62 |
Where Ohio sits
The same service costs 6.9 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 $7,377MT $1,063
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.