How much rates vary
Facilitymedian $4,074 · 10th to 90th $794 to $11,749Professionalmedian $776 · 10th to 90th $501 to $1,230
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 $1,584.89 Median $5,128.61 Typical High $12,589.25 | Facility | None | $1,584.89 | $5,128.61 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $8,511.38 | Professional | None | $691.83 | $812.83 | $8,511.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $3,715.35 Typical High $19,054.61 | Facility | None | $1,000.00 | $3,715.35 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,380.38 | Professional | None | $676.08 | $794.33 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,202.26 Typical High $2,041.74 | Professional | 50 · Both sides | $1,023.29 | $1,202.26 | $2,041.74 |
CareSource Setting Facility Modifier None Typical Low $851.14 Median $4,570.88 Typical High $6,025.60 | Facility | None | $851.14 | $4,570.88 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $4,786.30 Typical High $7,943.28 | Facility | None | $549.54 | $4,786.30 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,778.28 | Professional | None | $660.69 | $954.99 | $1,778.28 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $4,786.30 Typical High $7,585.78 | Facility | None | $549.54 | $4,786.30 | $7,585.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,778.28 | Professional | None | $660.69 | $954.99 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $691.83 Typical High $933.25 | Professional | None | $57.54 | $691.83 | $933.25 |
SummaCare Setting Facility Modifier None Typical Low $2,570.40 Median $2,691.53 Typical High $3,090.30 | Facility | None | $2,570.40 | $2,691.53 | $3,090.30 |
SummaCare Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $1,778.28 | Professional | None | $645.65 | $676.08 | $1,778.28 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,120.11 | Facility | None | $851.14 | $2,818.38 | $9,120.11 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,819.70 | Professional | None | $758.58 | $1,000.00 | $1,819.70 |
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 $346.74 Median $346.74 Typical High $1,698.24 | Professional | 52 · Reduced service | $346.74 | $346.74 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $676.08 | Professional | 53 · Discontinued | $138.04 | $138.04 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $2,570.40 | Professional | 54 · Surgery only | $524.81 | $524.81 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $512.86 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $338.84 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $2,398.83 |
Where Ohio sits
The same service costs 6.6 times more in Colorado than in Kentucky. 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 $14,612KY $2,222
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.