How much rates vary
Facilitymedian $1,698 · 10th to 90th $468 to $7,413Professionalmedian $214 · 10th to 90th $178 to $389
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 $575.44 Median $2,630.27 Typical High $12,022.64 | Facility | None | $575.44 | $2,630.27 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $218.78 Typical High $3,235.94 | Professional | None | $213.80 | $218.78 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,659.59 Typical High $7,585.78 | Facility | None | $562.34 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $331.13 | Professional | None | $177.83 | $213.80 | $331.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $263.03 Median $323.59 Typical High $489.78 | Professional | 50 · Both sides | $263.03 | $323.59 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $257.04 Median $1,584.89 Typical High $2,089.30 | Facility | None | $257.04 | $1,584.89 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,659.59 Typical High $2,630.27 | Facility | None | $363.08 | $1,659.59 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $426.58 | Professional | None | $194.98 | $229.09 | $426.58 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $1,659.59 Typical High $2,570.40 | Facility | None | $389.05 | $1,659.59 | $2,570.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $426.58 | Professional | None | $194.98 | $229.09 | $426.58 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $275.42 | Professional | None | $162.18 | $204.17 | $275.42 |
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 $194.98 Median $194.98 Typical High $302.00 | Professional | None | $194.98 | $194.98 | $302.00 |
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 $194.98 Median $239.88 Typical High $478.63 | Professional | None | $194.98 | $239.88 | $478.63 |
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 $107.15 Median $107.15 Typical High $426.58 | Professional | 52 · Reduced service | $107.15 | $107.15 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $169.82 | Professional | 53 · Discontinued | $42.66 | $42.66 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $630.96 | Professional | 54 · Surgery only | $162.18 | $162.18 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $125.89 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $85.11 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $151.36 | $151.36 | $588.84 |
Where Ohio sits
The same service costs 9.6 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 $6,197MT $647
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.