How much rates vary
Facilitymedian $2,692 · 10th to 90th $603 to $8,128Professionalmedian $309 · 10th to 90th $245 to $468
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 $1,513.56 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,513.56 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $1,380.38 | Professional | None | $281.84 | $281.84 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $7,079.46 | Facility | None | $758.58 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $446.68 | Professional | None | $281.84 | $331.13 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $4,073.80 Typical High $5,248.07 | Facility | None | $346.74 | $4,073.80 | $5,248.07 |
CareSource Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $338.84 | Professional | None | $295.12 | $295.12 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $4,265.80 Typical High $6,760.83 | Facility | None | $588.84 | $4,265.80 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $575.44 | Professional | None | $275.42 | $302.00 | $575.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $4,265.80 Typical High $6,760.83 | Facility | None | $588.84 | $4,265.80 | $6,760.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $562.34 | Professional | None | $275.42 | $302.00 | $562.34 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $426.58 | Professional | None | $223.87 | $281.84 | $426.58 |
SummaCare Setting Facility Modifier None Typical Low $4,570.88 Median $4,786.30 Typical High $5,495.41 | Facility | None | $4,570.88 | $4,786.30 | $5,495.41 |
SummaCare Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $302.00 | Professional | None | $263.03 | $263.03 | $302.00 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,786.30 | Facility | None | $501.19 | $977.24 | $4,786.30 |
United Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $501.19 | Professional | None | $239.88 | $331.13 | $501.19 |
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 $141.25 Median $141.25 Typical High $186.21 | Professional | 52 · Reduced service | $141.25 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $75.86 | Professional | 53 · Discontinued | $56.23 | $56.23 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $281.84 | Professional | 54 · Surgery only | $213.80 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $56.23 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $37.15 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $37.15 |
Where Ohio sits
The same service costs 7.8 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 $7,005MT $893
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.