How much rates vary
Facilitymedian $1,413 · 10th to 90th $417 to $5,754Professionalmedian $339 · 10th to 90th $98 to $575
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 $354.81 Median $1,995.26 Typical High $10,964.78 | Facility | None | $354.81 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $416.87 Typical High $707.95 | Professional | None | $128.82 | $416.87 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $4,466.84 | Facility | None | $489.78 | $1,258.93 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $190.55 Typical High $489.78 | Professional | None | $102.33 | $190.55 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $158.49 Median $1,348.96 Typical High $1,737.80 | Facility | None | $158.49 | $1,348.96 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $151.36 | Professional | None | $134.90 | $134.90 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,479.11 Typical High $2,290.87 | Facility | None | $389.05 | $1,479.11 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $338.84 Typical High $602.56 | Professional | None | $128.82 | $338.84 | $602.56 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $1,479.11 Typical High $2,187.76 | Facility | None | $389.05 | $1,479.11 | $2,187.76 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $128.82 Median $338.84 Typical High $575.44 | Professional | None | $128.82 | $338.84 | $575.44 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $380.19 Typical High $630.96 | Professional | None | $30.90 | $380.19 | $630.96 |
SummaCare Setting Facility Modifier None Typical Low $741.31 Median $776.25 Typical High $870.96 | Facility | None | $741.31 | $776.25 | $870.96 |
SummaCare Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $524.81 | Professional | None | $123.03 | $186.21 | $524.81 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $114.82 Median $309.03 Typical High $537.03 | Professional | None | $114.82 | $309.03 | $537.03 |
6 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 $64.57 Median $204.17 Typical High $208.93 | Professional | 52 · Reduced service | $64.57 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $81.28 Typical High $83.18 | Professional | 53 · Discontinued | $25.70 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $309.03 Typical High $316.23 | Professional | 54 · Surgery only | $95.50 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $61.66 Typical High $63.10 | Professional | 55 · Aftercare only | $19.05 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $40.74 Typical High $41.69 | Professional | 56 · Pre-op care only | $12.88 | $40.74 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $288.40 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $89.13 | $288.40 | $295.12 |
Where Ohio sits
The same service costs 5.6 times more in Colorado than in North Dakota. 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 $4,763ND $853
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.