How much rates vary
Facilitymedian $1,122 · 10th to 90th $501 to $5,248Professionalmedian $219 · 10th to 90th $166 to $363
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 $1,412.54 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,412.54 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $933.25 | Professional | None | $194.98 | $194.98 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,174.90 Typical High $4,570.88 | Facility | None | $524.81 | $1,174.90 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $354.81 | Professional | None | $213.80 | $251.19 | $354.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $134.90 Median $158.49 Typical High $223.87 | Professional | 62 · Two surgeons | $134.90 | $158.49 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $239.88 Median $831.76 Typical High $1,096.48 | Facility | None | $239.88 | $831.76 | $1,096.48 |
CareSource Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $229.09 | Professional | None | $204.17 | $204.17 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $954.99 Typical High $1,995.26 | Facility | None | $489.78 | $954.99 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $501.19 | Professional | None | $194.98 | $208.93 | $501.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $954.99 Typical High $1,995.26 | Facility | None | $512.86 | $954.99 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $199.53 Median $208.93 Typical High $478.63 | Professional | None | $199.53 | $208.93 | $478.63 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $269.15 | Professional | None | $138.04 | $177.83 | $269.15 |
SummaCare Setting Facility Modifier None Typical Low $457.09 Median $478.63 Typical High $549.54 | Facility | None | $457.09 | $478.63 | $549.54 |
SummaCare Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $213.80 | Professional | None | $181.97 | $181.97 | $213.80 |
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 $173.78 Median $257.04 Typical High $426.58 | Professional | None | $173.78 | $257.04 | $426.58 |
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 $97.72 Typical High $177.83 | Professional | 52 · Reduced service | $97.72 | $97.72 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $70.79 | Professional | 53 · Discontinued | $38.90 | $38.90 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $269.15 | Professional | 54 · Surgery only | $144.54 | $144.54 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $53.70 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $35.48 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $35.48 |
Where Ohio sits
The same service costs 6.8 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 $4,179MT $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.