How much rates vary
Facilitymedian $1,072 · 10th to 90th $525 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 $549.54 Median $2,754.23 Typical High $10,964.78 | Facility | None | $549.54 | $2,754.23 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $812.83 Typical High $1,071.52 | Professional | None | $190.55 | $812.83 | $1,071.52 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $165.96 | Professional | None | $141.25 | $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 $691.83 Typical High $891.25 | Facility | None | $234.42 | $691.83 | $891.25 |
CareSource Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,174.90 | Professional | None | $741.31 | $812.83 | $1,174.90 |
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 $467.74 Typical High $1,122.02 | Professional | None | $199.53 | $467.74 | $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 $457.09 Typical High $1,122.02 | Professional | None | $199.53 | $457.09 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,288.25 | Professional | None | $630.96 | $812.83 | $1,288.25 |
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 |
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 $95.50 Median $389.05 Typical High $416.87 | Professional | 52 · Reduced service | $95.50 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $154.88 Typical High $165.96 | Professional | 53 · Discontinued | $38.02 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $588.84 Typical High $616.60 | Professional | 54 · Surgery only | $141.25 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $117.49 Typical High $123.03 | Professional | 55 · Aftercare only | $28.18 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $77.62 Typical High $83.18 | Professional | 56 · Pre-op care only | $19.05 | $77.62 | $83.18 |
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 $982
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.