How much rates vary
Facilitymedian $1,820 · 10th to 90th $490 to $8,128Professionalmedian $380 · 10th to 90th $257 to $617
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 $660.69 Median $2,344.23 Typical High $11,220.18 | Facility | None | $660.69 | $2,344.23 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $398.11 Typical High $3,235.94 | Professional | None | $371.54 | $398.11 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,698.24 Typical High $7,585.78 | Facility | None | $562.34 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $549.54 | Professional | None | $269.15 | $323.59 | $549.54 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $1,584.89 Typical High $2,089.30 | Facility | None | $446.68 | $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 $331.13 Median $389.05 Typical High $741.31 | Professional | None | $331.13 | $389.05 | $741.31 |
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 $331.13 Median $389.05 Typical High $758.58 | Professional | None | $331.13 | $389.05 | $758.58 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $398.11 Typical High $562.34 | Professional | None | $47.86 | $398.11 | $562.34 |
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 $346.74 Median $346.74 Typical High $524.81 | Professional | None | $346.74 | $346.74 | $524.81 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $8,709.64 | Facility | None | $851.14 | $2,630.27 | $8,709.64 |
United Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $851.14 | Professional | None | $323.59 | $407.38 | $851.14 |
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 $186.21 Median $186.21 Typical High $660.69 | Professional | 52 · Reduced service | $186.21 | $186.21 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $263.03 | Professional | 53 · Discontinued | $75.86 | $75.86 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $1,000.00 | Professional | 54 · Surgery only | $281.84 | $281.84 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $199.53 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $131.83 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $933.25 |
Where Ohio sits
The same service costs 5.9 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 $6,847MT $1,164
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.