How much rates vary
Facilitymedian $1,318 · 10th to 90th $550 to $6,918Professionalmedian $162 · 10th to 90th $110 to $234
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 $1,479.11 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,479.11 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $812.83 | Professional | None | $147.91 | $147.91 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $234.42 | Professional | None | $144.54 | $173.78 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $186.21 Median $1,096.48 Typical High $1,412.54 | Facility | None | $186.21 | $1,096.48 | $1,412.54 |
CareSource Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $177.83 | Professional | None | $158.49 | $158.49 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $977.24 Typical High $2,951.21 | Facility | None | $588.84 | $977.24 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $295.12 | Professional | None | $144.54 | $162.18 | $295.12 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $977.24 Typical High $2,951.21 | Facility | None | $588.84 | $977.24 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $295.12 | Professional | None | $144.54 | $162.18 | $295.12 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $194.98 | Professional | None | $91.20 | $123.03 | $194.98 |
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 $138.04 Median $138.04 Typical High $162.18 | Professional | None | $138.04 | $138.04 | $162.18 |
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 $128.82 Median $169.82 Typical High $257.04 | Professional | None | $128.82 | $169.82 | $257.04 |
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 $74.13 Median $74.13 Typical High $100.00 | Professional | 52 · Reduced service | $74.13 | $74.13 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $39.81 | Professional | 53 · Discontinued | $29.51 | $29.51 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $112.20 Typical High $151.36 | Professional | 54 · Surgery only | $112.20 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $30.20 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $19.95 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $19.95 |
Where Ohio sits
The same service costs 11.1 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 $5,221MT $469
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.