How much rates vary
Facilitymedian $813 · 10th to 90th $251 to $4,786Professionalmedian $158 · 10th to 90th $50 to $355
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 $208.93 Median $1,995.26 Typical High $10,964.78 | Facility | None | $208.93 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $257.04 Typical High $467.74 | Professional | None | $74.13 | $257.04 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $4,570.88 | Facility | None | $524.81 | $1,122.02 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $70.79 Typical High $229.09 | Professional | None | $42.66 | $70.79 | $229.09 |
CareSource Setting Facility Modifier None Typical Low $93.33 Median $208.93 Typical High $275.42 | Facility | None | $93.33 | $208.93 | $275.42 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $89.13 | Professional | None | $79.43 | $79.43 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $398.11 Typical High $2,398.83 | Facility | None | $251.19 | $398.11 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $208.93 Typical High $354.81 | Professional | None | $75.86 | $208.93 | $354.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $251.19 Median $398.11 Typical High $2,398.83 | Facility | None | $251.19 | $398.11 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $75.86 Median $208.93 Typical High $354.81 | Professional | None | $75.86 | $208.93 | $354.81 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $478.63 | Professional | None | $234.42 | $302.00 | $478.63 |
SummaCare Setting Facility Modifier None Typical Low $134.90 Median $141.25 Typical High $162.18 | Facility | None | $134.90 | $141.25 | $162.18 |
SummaCare Setting Professional Modifier None Typical Low $72.44 Median $109.65 Typical High $346.74 | Professional | None | $72.44 | $109.65 | $346.74 |
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 $64.57 Median $158.49 Typical High $302.00 | Professional | None | $64.57 | $158.49 | $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 $37.15 Median $131.83 Typical High $134.90 | Professional | 52 · Reduced service | $37.15 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $52.48 Typical High $53.70 | Professional | 53 · Discontinued | $14.79 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $199.53 Typical High $199.53 | Professional | 54 · Surgery only | $56.23 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $39.81 Typical High $40.74 | Professional | 55 · Aftercare only | $11.22 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $26.30 Typical High $26.92 | Professional | 56 · Pre-op care only | $7.41 | $26.30 | $26.92 |
Where Ohio sits
The same service costs 9.0 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 $4,579MT $507
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.