How much rates vary
Facilitymedian $1,585 · 10th to 90th $575 to $7,244Professionalmedian $501 · 10th to 90th $324 to $676
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 $1,380.38 Median $5,754.40 Typical High $12,022.64 | Facility | None | $1,380.38 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,862.09 | Professional | None | $501.19 | $501.19 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,202.26 Typical High $4,786.30 | Facility | None | $562.34 | $1,202.26 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $707.95 | Professional | None | $426.58 | $501.19 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $616.60 Median $1,348.96 Typical High $1,737.80 | Facility | None | $616.60 | $1,348.96 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $602.56 | Professional | None | $524.81 | $524.81 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,584.89 Typical High $2,691.53 | Facility | None | $562.34 | $1,584.89 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $954.99 | Professional | None | $478.63 | $512.86 | $954.99 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,584.89 Typical High $2,691.53 | Facility | None | $602.56 | $1,584.89 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $912.01 | Professional | None | $478.63 | $512.86 | $912.01 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $407.38 Typical High $616.60 | Professional | None | $56.23 | $407.38 | $616.60 |
SummaCare Setting Facility Modifier None Typical Low $758.58 Median $794.33 Typical High $912.01 | Facility | None | $758.58 | $794.33 | $912.01 |
SummaCare Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $524.81 | Professional | None | $457.09 | $457.09 | $524.81 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,786.30 | Facility | None | $501.19 | $977.24 | $4,786.30 |
United Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $812.83 | Professional | None | $416.87 | $524.81 | $812.83 |
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 $251.19 Median $251.19 Typical High $331.13 | Professional | 52 · Reduced service | $251.19 | $251.19 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $131.83 | Professional | 53 · Discontinued | $100.00 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $489.78 | Professional | 54 · Surgery only | $380.19 | $380.19 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $100.00 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $66.07 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $457.09 |
Where Ohio sits
The same service costs 3.9 times more in Colorado than in Delaware. 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 $5,057DE $1,284
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.