How much rates vary
Facilitymedian $1,072 · 10th to 90th $550 to $9,333Professionalmedian $257 · 10th to 90th $178 to $479
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 $575.44 Median $9,120.11 Typical High $12,589.25 | Facility | None | $575.44 | $9,120.11 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $10,232.93 | Professional | None | $199.53 | $199.53 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,258.93 Typical High $4,677.35 | Facility | None | $524.81 | $1,258.93 | $4,677.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $436.52 | Professional | None | $218.78 | $302.00 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $251.19 Median $851.14 Typical High $1,096.48 | Facility | None | $251.19 | $851.14 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $933.25 Typical High $2,398.83 | Facility | None | $549.54 | $933.25 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $575.44 | Professional | None | $186.21 | $229.09 | $575.44 |
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 $186.21 Median $223.87 Typical High $602.56 | Professional | None | $186.21 | $223.87 | $602.56 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $275.42 | Professional | None | $162.18 | $208.93 | $275.42 |
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 $177.83 Median $177.83 Typical High $338.84 | Professional | None | $177.83 | $177.83 | $338.84 |
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 $190.55 Median $288.40 Typical High $512.86 | Professional | None | $190.55 | $288.40 | $512.86 |
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 $100.00 Median $100.00 Typical High $776.25 | Professional | 52 · Reduced service | $100.00 | $100.00 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $309.03 | Professional | 53 · Discontinued | $39.81 | $39.81 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $1,148.15 | Professional | 54 · Surgery only | $147.91 | $147.91 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $229.09 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $154.88 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $154.88 |
Where Ohio sits
The same service costs 7.6 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 $4,681MT $618
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.