How much rates vary
Facilitymedian $1,820 · 10th to 90th $525 to $5,888Professionalmedian $708 · 10th to 90th $174 to $1,698
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 $489.78 Median $2,691.53 Typical High $10,964.78 | Facility | None | $489.78 | $2,691.53 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $707.95 Typical High $2,630.27 | Professional | None | $173.78 | $707.95 | $2,630.27 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,202.26 Typical High $4,570.88 | Facility | None | $524.81 | $1,202.26 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $524.81 Typical High $2,290.87 | Professional | None | $173.78 | $524.81 | $2,290.87 |
CareSource Setting Facility Modifier None Typical Low $213.80 Median $1,584.89 Typical High $2,089.30 | Facility | None | $213.80 | $1,584.89 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,778.28 Typical High $2,630.27 | Facility | None | $489.78 | $1,778.28 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $575.44 Typical High $1,096.48 | Professional | None | $169.82 | $575.44 | $1,096.48 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,778.28 Typical High $2,570.40 | Facility | None | $512.86 | $1,778.28 | $2,570.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $169.82 Median $575.44 Typical High $1,096.48 | Professional | None | $169.82 | $575.44 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,148.15 | Professional | None | $616.60 | $851.14 | $1,148.15 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,047.13 | Facility | None | $891.25 | $933.25 | $1,047.13 |
SummaCare Setting Professional Modifier None Typical Low $158.49 Median $707.95 Typical High $870.96 | Professional | None | $158.49 | $707.95 | $870.96 |
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 $181.97 Median $575.44 Typical High $1,445.44 | Professional | None | $181.97 | $575.44 | $1,445.44 |
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 $87.10 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $87.10 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $34.67 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $128.82 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $25.70 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $17.38 | $70.79 | $70.79 |
Where Ohio sits
The same service costs 4.0 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 $5,041MT $1,267
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.