How much rates vary
Facilitymedian $1,514 · 10th to 90th $603 to $5,888Professionalmedian $288 · 10th to 90th $58 to $479
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 $741.31 Median $3,311.31 Typical High $11,220.18 | Facility | None | $741.31 | $3,311.31 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $831.76 | Professional | None | $316.23 | $331.13 | $831.76 |
Ambetter Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $4,570.88 | Facility | None | $537.03 | $1,258.93 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $331.13 | Professional | None | $158.49 | $204.17 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $1,348.96 Typical High $1,737.80 | Facility | None | $416.87 | $1,348.96 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $398.11 | Professional | None | $354.81 | $354.81 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,513.56 Typical High $2,691.53 | Facility | None | $549.54 | $1,513.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $549.54 | Professional | None | $281.84 | $346.74 | $549.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $1,513.56 Typical High $2,630.27 | Facility | None | $549.54 | $1,513.56 | $2,630.27 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $537.03 | Professional | None | $302.00 | $346.74 | $537.03 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $316.23 Typical High $501.19 | Professional | None | $31.62 | $316.23 | $501.19 |
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 $346.74 Median $346.74 Typical High $407.38 | Professional | None | $346.74 | $346.74 | $407.38 |
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 $199.53 Median $275.42 Typical High $446.68 | Professional | None | $199.53 | $275.42 | $446.68 |
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 $165.96 Median $165.96 Typical High $213.80 | Professional | 52 · Reduced service | $165.96 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $87.10 | Professional | 53 · Discontinued | $66.07 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $323.59 | Professional | 54 · Surgery only | $251.19 | $251.19 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $64.57 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $302.00 |
Where Ohio sits
The same service costs 5.5 times more in Colorado than in Michigan. 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 $4,792MI $877
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.