How much rates vary
Facilitymedian $1,096 · 10th to 90th $501 to $6,026Professionalmedian $708 · 10th to 90th $191 to $1,148
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 $524.81 Median $2,691.53 Typical High $10,715.19 | Facility | None | $524.81 | $2,691.53 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $812.83 Typical High $1,258.93 | Professional | None | $190.55 | $812.83 | $1,258.93 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
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 $177.83 Median $602.56 Typical High $1,047.13 | Professional | None | $177.83 | $602.56 | $1,047.13 |
CareSource Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
CareSource Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $229.09 | Professional | None | $199.53 | $199.53 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $831.76 Typical High $6,025.60 | Facility | None | $549.54 | $831.76 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $478.63 Typical High $1,122.02 | Professional | None | $199.53 | $478.63 | $1,122.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $831.76 Typical High $6,025.60 | Facility | None | $549.54 | $831.76 | $6,025.60 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $199.53 Median $446.68 Typical High $1,122.02 | Professional | None | $199.53 | $446.68 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,318.26 | Professional | None | $660.69 | $851.14 | $1,318.26 |
SummaCare Setting Facility Modifier None Typical Low $380.19 Median $398.11 Typical High $457.09 | Facility | None | $380.19 | $398.11 | $457.09 |
SummaCare Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $954.99 | Professional | None | $173.78 | $263.03 | $954.99 |
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 $181.97 Median $602.56 Typical High $1,202.26 | Professional | None | $181.97 | $602.56 | $1,202.26 |
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 $95.50 Median $407.38 Typical High $426.58 | Professional | 52 · Reduced service | $95.50 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $165.96 Typical High $169.82 | Professional | 53 · Discontinued | $38.02 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $616.60 Typical High $630.96 | Professional | 54 · Surgery only | $141.25 | $616.60 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $123.03 Typical High $125.89 | Professional | 55 · Aftercare only | $28.18 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $81.28 Typical High $85.11 | Professional | 56 · Pre-op care only | $19.05 | $81.28 | $85.11 |
Ambetter Setting Professional Modifier 76 · Repeat, same provider Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 76 · Repeat, same provider | $165.96 | $165.96 | $165.96 |
Where Ohio sits
The same service costs 5.2 times more in Colorado than in Maryland. 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 $5,090MD $977
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.