How much rates vary
Facilitymedian $1,778 · 10th to 90th $537 to $5,754Professionalmedian $741 · 10th to 90th $162 to $1,660
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 $371.54 Median $2,344.23 Typical High $10,715.19 | Facility | None | $371.54 | $2,344.23 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $741.31 Typical High $2,691.53 | Professional | None | $199.53 | $741.31 | $2,691.53 |
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 $158.49 Median $602.56 Typical High $2,137.96 | Professional | None | $158.49 | $602.56 | $2,137.96 |
CareSource Setting Facility Modifier None Typical Low $245.47 Median $1,584.89 Typical High $2,089.30 | Facility | None | $245.47 | $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 $199.53 Median $616.60 Typical High $1,174.90 | Professional | None | $199.53 | $616.60 | $1,174.90 |
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 $199.53 Median $616.60 Typical High $1,174.90 | Professional | None | $199.53 | $616.60 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,202.26 | Professional | None | $660.69 | $891.25 | $1,202.26 |
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 $181.97 Median $741.31 Typical High $977.24 | Professional | None | $181.97 | $741.31 | $977.24 |
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 $186.21 Median $630.96 Typical High $1,445.44 | Professional | None | $186.21 | $630.96 | $1,445.44 |
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 $100.00 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $100.00 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $39.81 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $151.36 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $30.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $19.95 | $74.13 | $74.13 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $165.96 |
Where Ohio sits
The same service costs 3.8 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 $5,124MT $1,344
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.