How much rates vary
Facilitymedian $1,096 · 10th to 90th $501 to $5,248Professionalmedian $186 · 10th to 90th $132 to $324
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 $177.83 Median $177.83 Typical High $724.44 | Professional | None | $177.83 | $177.83 | $724.44 |
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 $158.49 Median $186.21 Typical High $331.13 | Professional | None | $158.49 | $186.21 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $831.76 Typical High $1,096.48 | Facility | None | $218.78 | $831.76 | $1,096.48 |
CareSource Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $213.80 | Professional | None | $186.21 | $186.21 | $213.80 |
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 $173.78 Median $190.55 Typical High $338.84 | Professional | None | $173.78 | $190.55 | $338.84 |
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 $173.78 Median $190.55 Typical High $338.84 | Professional | None | $173.78 | $190.55 | $338.84 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $213.80 | Professional | None | $112.20 | $138.04 | $213.80 |
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 $165.96 Median $165.96 Typical High $194.98 | Professional | None | $165.96 | $165.96 | $194.98 |
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 $151.36 Median $194.98 Typical High $302.00 | Professional | None | $151.36 | $194.98 | $302.00 |
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 $89.13 Median $89.13 Typical High $117.49 | Professional | 52 · Reduced service | $89.13 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $46.77 | Professional | 53 · Discontinued | $35.48 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $177.83 | Professional | 54 · Surgery only | $131.83 | $131.83 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $35.48 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $23.44 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $23.44 |
Where Ohio sits
The same service costs 7.3 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 $4,136MT $564
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.