How much rates vary
Facilitymedian $1,072 · 10th to 90th $316 to $5,012Professionalmedian $162 · 10th to 90th $95 to $331
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 $177.83 Median $512.86 Typical High $10,715.19 | Facility | None | $177.83 | $512.86 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $724.44 | Professional | None | $97.72 | $151.36 | $724.44 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $138.04 | Professional | None | $70.79 | $83.18 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $1,202.26 Typical High $4,466.84 | Facility | None | $467.74 | $1,202.26 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $190.55 Typical High $478.63 | Professional | None | $97.72 | $190.55 | $478.63 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $933.25 Typical High $1,202.26 | Facility | None | $117.49 | $933.25 | $1,202.26 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $186.21 | Professional | None | $165.96 | $173.78 | $186.21 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $154.88 Typical High $302.00 | Professional | None | $95.50 | $154.88 | $302.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $1,071.52 Typical High $1,737.80 | Facility | None | $389.05 | $1,071.52 | $1,737.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $95.50 Median $154.88 Typical High $309.03 | Professional | None | $95.50 | $154.88 | $309.03 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $218.78 | Professional | None | $123.03 | $162.18 | $218.78 |
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 $87.10 Median $151.36 Typical High $229.09 | Professional | None | $87.10 | $151.36 | $229.09 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $5,888.44 | Facility | None | $691.83 | $1,445.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $93.33 Median $158.49 Typical High $281.84 | Professional | None | $93.33 | $158.49 | $281.84 |
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 $48.98 Median $74.13 Typical High $75.86 | Professional | 52 · Reduced service | $48.98 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $29.51 Typical High $30.20 | Professional | 53 · Discontinued | $19.50 | $29.51 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $109.65 Typical High $112.20 | Professional | 54 · Surgery only | $74.13 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $14.79 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $14.79 Typical High $15.14 | Professional | 56 · Pre-op care only | $9.77 | $14.79 | $15.14 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $95.50 Median $100.00 Typical High $117.49 | Professional | GC · Resident with teaching physician | $95.50 | $100.00 | $117.49 |
Where Ohio sits
The same service costs 12.7 times more in Colorado than in North Dakota. 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 $4,551ND $359
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.