How much rates vary
Facilitymedian $2,344 · 10th to 90th $457 to $7,413Professionalmedian $457 · 10th to 90th $331 to $794
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 $562.34 Median $3,235.94 Typical High $12,589.25 | Facility | None | $562.34 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $2,344.23 | Professional | None | $346.74 | $426.58 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $2,137.96 Typical High $7,079.46 | Facility | None | $562.34 | $2,137.96 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $660.69 | Professional | None | $295.12 | $398.11 | $660.69 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $602.56 Typical High $977.24 | Professional | 50 · Both sides | $436.52 | $602.56 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $2,454.71 Typical High $3,162.28 | Facility | None | $426.58 | $2,454.71 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $2,570.40 Typical High $4,168.69 | Facility | None | $363.08 | $2,570.40 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $851.14 | Professional | None | $338.84 | $457.09 | $851.14 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $2,570.40 Typical High $4,073.80 | Facility | None | $389.05 | $2,570.40 | $4,073.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $891.25 | Professional | None | $338.84 | $457.09 | $891.25 |
Molina Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $776.25 | Professional | None | $457.09 | $575.44 | $776.25 |
SummaCare Setting Facility Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,659.59 | Facility | None | $1,412.54 | $1,479.11 | $1,659.59 |
SummaCare Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $588.84 | Professional | None | $316.23 | $446.68 | $588.84 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $851.14 | Professional | None | $354.81 | $489.78 | $851.14 |
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 $173.78 Median $213.80 Typical High $223.87 | Professional | 52 · Reduced service | $173.78 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $85.11 Typical High $89.13 | Professional | 53 · Discontinued | $69.18 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $316.23 Typical High $331.13 | Professional | 54 · Surgery only | $263.03 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $63.10 Typical High $66.07 | Professional | 55 · Aftercare only | $52.48 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $42.66 Typical High $44.67 | Professional | 56 · Pre-op care only | $34.67 | $42.66 | $44.67 |
Where Ohio sits
The same service costs 6.3 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 $7,350MT $1,166
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.