How much rates vary
Facilitymedian $977 · 10th to 90th $525 to $5,248Professionalmedian $245 · 10th to 90th $195 to $380
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 $707.95 Median $3,548.13 Typical High $12,022.64 | Facility | None | $707.95 | $3,548.13 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $1,202.26 | Professional | None | $245.47 | $245.47 | $1,202.26 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $302.00 | Professional | None | $173.78 | $204.17 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $616.60 Typical High $794.33 | Facility | None | $302.00 | $616.60 | $794.33 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $295.12 | Professional | None | $257.04 | $257.04 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $741.31 Typical High $2,951.21 | Facility | None | $549.54 | $741.31 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $389.05 | Professional | None | $234.42 | $269.15 | $389.05 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $741.31 Typical High $2,951.21 | Facility | None | $549.54 | $741.31 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $389.05 | Professional | None | $234.42 | $269.15 | $389.05 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $363.08 | Professional | None | $194.98 | $245.47 | $363.08 |
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 $223.87 Median $223.87 Typical High $263.03 | Professional | None | $223.87 | $223.87 | $263.03 |
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 $213.80 Median $281.84 Typical High $426.58 | Professional | None | $213.80 | $281.84 | $426.58 |
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 $123.03 Median $123.03 Typical High $177.83 | Professional | 52 · Reduced service | $123.03 | $123.03 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $70.79 | Professional | 53 · Discontinued | $48.98 | $48.98 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $269.15 | Professional | 54 · Surgery only | $186.21 | $186.21 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $53.70 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $35.48 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $35.48 |
Where Ohio sits
The same service costs 5.6 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 $4,320MT $769
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.