How much rates vary
Facilitymedian $933 · 10th to 90th $417 to $4,786Professionalmedian $191 · 10th to 90th $132 to $302
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 $457.09 Median $2,630.27 Typical High $12,022.64 | Facility | None | $457.09 | $2,630.27 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $812.83 | Professional | None | $165.96 | $165.96 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $186.21 | Professional | None | $147.91 | $147.91 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $1,202.26 Typical High $4,570.88 | Facility | None | $467.74 | $1,202.26 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $302.00 | Professional | None | $186.21 | $223.87 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $204.17 Median $616.60 Typical High $794.33 | Facility | None | $204.17 | $616.60 | $794.33 |
CareSource Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | None | $173.78 | $173.78 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $691.83 Typical High $1,479.11 | Facility | None | $389.05 | $691.83 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $380.19 | Professional | None | $162.18 | $177.83 | $380.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $691.83 Typical High $1,479.11 | Facility | None | $389.05 | $691.83 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $380.19 | Professional | None | $162.18 | $177.83 | $380.19 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $213.80 | Professional | None | $112.20 | $141.25 | $213.80 |
SummaCare Setting Facility Modifier None Typical Low $338.84 Median $354.81 Typical High $407.38 | Facility | None | $338.84 | $354.81 | $407.38 |
SummaCare Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $181.97 | Professional | None | $154.88 | $154.88 | $181.97 |
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 $141.25 Median $218.78 Typical High $309.03 | Professional | None | $141.25 | $218.78 | $309.03 |
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 $83.18 Median $83.18 Typical High $114.82 | Professional | 52 · Reduced service | $83.18 | $83.18 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $45.71 | Professional | 53 · Discontinued | $33.11 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $173.78 | Professional | 54 · Surgery only | $125.89 | $125.89 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $34.67 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $22.91 |
Where Ohio sits
The same service costs 7.7 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 $4,047MT $526
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.