How much rates vary
Facilitymedian $1,072 · 10th to 90th $490 to $4,786Professionalmedian $389 · 10th to 90th $195 to $871
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 $1,995.26 Typical High $10,715.19 | Facility | None | $363.08 | $1,995.26 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $588.84 Typical High $933.25 | Professional | None | $194.98 | $588.84 | $933.25 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $213.80 | Professional | None | $151.36 | $199.53 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,148.15 Typical High $4,466.84 | Facility | None | $524.81 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $660.69 | Professional | None | $229.09 | $269.15 | $660.69 |
Aultcare Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $346.74 | Professional | None | $204.17 | $204.17 | $346.74 |
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 $524.81 Median $588.84 Typical High $851.14 | Professional | None | $524.81 | $588.84 | $851.14 |
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 $204.17 Median $489.78 Typical High $794.33 | Professional | None | $204.17 | $489.78 | $794.33 |
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 $204.17 Median $426.58 Typical High $776.25 | Professional | None | $204.17 | $426.58 | $776.25 |
Molina Setting Professional Modifier None Typical Low $371.54 Median $645.65 Typical High $1,023.29 | Professional | None | $371.54 | $645.65 | $1,023.29 |
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 $275.42 Typical High $794.33 | Professional | None | $181.97 | $275.42 | $794.33 |
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 $181.97 Median $331.13 Typical High $812.83 | Professional | None | $181.97 | $331.13 | $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 $97.72 Median $288.40 Typical High $295.12 | Professional | 52 · Reduced service | $97.72 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $114.82 Typical High $117.49 | Professional | 53 · Discontinued | $38.90 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $436.52 Typical High $446.68 | Professional | 54 · Surgery only | $144.54 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $87.10 Typical High $89.13 | Professional | 55 · Aftercare only | $29.51 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $57.54 Typical High $58.88 | Professional | 56 · Pre-op care only | $19.50 | $57.54 | $58.88 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 59 · Distinct service | $269.15 | $269.15 | $269.15 |
Where Ohio sits
The same service costs 4.1 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 $4,259MT $1,038
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.