How much rates vary
Facilitymedian $3,090 · 10th to 90th $676 to $10,233Professionalmedian $324 · 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 $851.14 Median $5,754.40 Typical High $12,022.64 | Facility | None | $851.14 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $1,148.15 | Professional | None | $275.42 | $275.42 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,819.70 Typical High $7,585.78 | Facility | None | $630.96 | $1,819.70 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $478.63 | Professional | None | $281.84 | $331.13 | $478.63 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $3,090.30 Typical High $3,981.07 | Facility | None | $346.74 | $3,090.30 | $3,981.07 |
CareSource Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $331.13 | Professional | None | $295.12 | $295.12 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,162.28 Typical High $5,370.32 | Facility | None | $602.56 | $3,162.28 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $575.44 | Professional | None | $275.42 | $295.12 | $575.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $3,162.28 Typical High $5,128.61 | Facility | None | $602.56 | $3,162.28 | $5,128.61 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $575.44 | Professional | None | $275.42 | $295.12 | $575.44 |
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 $1,737.80 Median $1,819.70 Typical High $2,089.30 | Facility | None | $1,737.80 | $1,819.70 | $2,089.30 |
SummaCare Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $309.03 | Professional | None | $263.03 | $263.03 | $309.03 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $489.78 | Professional | None | $234.42 | $323.59 | $489.78 |
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 $138.04 Median $138.04 Typical High $177.83 | Professional | 52 · Reduced service | $138.04 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $72.44 | Professional | 53 · Discontinued | $54.95 | $54.95 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $269.15 | Professional | 54 · Surgery only | $204.17 | $204.17 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $53.70 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $36.31 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $36.31 |
Where Ohio sits
The same service costs 10.4 times more in Wyoming 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
WY $8,979MT $863
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.