How much rates vary
Facilitymedian $1,698 · 10th to 90th $490 to $5,888Professionalmedian $182 · 10th to 90th $123 to $302
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 $331.13 Median $3,311.31 Typical High $11,220.18 | Facility | None | $331.13 | $3,311.31 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $3,715.35 | Professional | None | $177.83 | $239.88 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,202.26 Typical High $4,466.84 | Facility | None | $524.81 | $1,202.26 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $331.13 | Professional | None | $151.36 | $199.53 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $223.87 Median $1,621.81 Typical High $2,089.30 | Facility | None | $223.87 | $1,621.81 | $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 $173.78 Median $229.09 Typical High $371.54 | Professional | None | $173.78 | $229.09 | $371.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,819.70 Typical High $2,570.40 | Facility | None | $512.86 | $1,819.70 | $2,570.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $389.05 | Professional | None | $173.78 | $229.09 | $389.05 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $239.88 | Professional | None | $109.65 | $165.96 | $239.88 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,071.52 | Facility | None | $891.25 | $933.25 | $1,071.52 |
SummaCare Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $346.74 | Professional | None | $165.96 | $173.78 | $346.74 |
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 $165.96 Median $218.78 Typical High $446.68 | Professional | None | $165.96 | $218.78 | $446.68 |
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 $89.13 Median $89.13 Typical High $426.58 | Professional | 52 · Reduced service | $89.13 | $89.13 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $169.82 | Professional | 53 · Discontinued | $35.48 | $35.48 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $645.65 | Professional | 54 · Surgery only | $131.83 | $131.83 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $128.82 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $85.11 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $123.03 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $123.03 | $123.03 | $602.56 |
Where Ohio sits
The same service costs 8.1 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 $4,634MT $570
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.