How much rates vary
Facilitymedian $1,122 · 10th to 90th $380 to $4,786Professionalmedian $83 · 10th to 90th $68 to $158
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 $213.80 Median $2,630.27 Typical High $12,022.64 | Facility | None | $213.80 | $2,630.27 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $3,548.13 | Professional | None | $75.86 | $75.86 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $1,148.15 Typical High $4,466.84 | Facility | None | $467.74 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $128.82 | Professional | None | $64.57 | $81.28 | $128.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $97.72 Median $123.03 Typical High $194.98 | Professional | 50 · Both sides | $97.72 | $123.03 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $933.25 Typical High $1,202.26 | Facility | None | $95.50 | $933.25 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,047.13 Typical High $1,659.59 | Facility | None | $363.08 | $1,047.13 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $251.19 | Professional | None | $74.13 | $87.10 | $251.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $1,071.52 Typical High $1,659.59 | Facility | None | $389.05 | $1,071.52 | $1,659.59 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $251.19 | Professional | None | $74.13 | $85.11 | $251.19 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $109.65 | Professional | None | $64.57 | $81.28 | $109.65 |
SummaCare Setting Facility Modifier None Typical Low $512.86 Median $537.03 Typical High $616.60 | Facility | None | $512.86 | $537.03 | $616.60 |
SummaCare Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $112.20 | Professional | None | $72.44 | $72.44 | $112.20 |
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 $74.13 Median $93.33 Typical High $181.97 | Professional | None | $74.13 | $93.33 | $181.97 |
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 $38.02 Median $38.02 Typical High $144.54 | Professional | 52 · Reduced service | $38.02 | $38.02 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $57.54 | Professional | 53 · Discontinued | $15.14 | $15.14 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $218.78 | Professional | 54 · Surgery only | $57.54 | $57.54 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $43.65 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $28.84 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $53.70 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $53.70 | $53.70 | $204.17 |
Where Ohio sits
The same service costs 18.4 times more in Colorado 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
CO $4,483MT $243
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.