How much rates vary
Facilitymedian $1,023 · 10th to 90th $407 to $5,012Professionalmedian $257 · 10th to 90th $191 to $479
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 $1,202.26 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,202.26 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $2,630.27 | Professional | None | $229.09 | $229.09 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $1,148.15 Typical High $4,466.84 | Facility | None | $467.74 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $398.11 | Professional | None | $204.17 | $257.04 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $316.23 Median $691.83 Typical High $891.25 | Facility | None | $316.23 | $691.83 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $1,479.11 | Facility | None | $363.08 | $794.33 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $512.86 | Professional | None | $251.19 | $346.74 | $512.86 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $794.33 Typical High $1,479.11 | Facility | None | $389.05 | $794.33 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $512.86 | Professional | None | $251.19 | $346.74 | $512.86 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $323.59 | Professional | None | $169.82 | $213.80 | $323.59 |
SummaCare Setting Facility Modifier None Typical Low $380.19 Median $398.11 Typical High $457.09 | Facility | None | $380.19 | $398.11 | $457.09 |
SummaCare Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $302.00 | Professional | None | $208.93 | $229.09 | $302.00 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $177.83 Median $354.81 Typical High $812.83 | Professional | None | $177.83 | $354.81 | $812.83 |
5 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 $114.82 Median $114.82 Typical High $588.84 | Professional | 52 · Reduced service | $114.82 | $114.82 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $234.42 | Professional | 53 · Discontinued | $45.71 | $45.71 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $891.25 | Professional | 54 · Surgery only | $169.82 | $169.82 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $177.83 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $117.49 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $117.49 |
Where Ohio sits
The same service costs 6.0 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 $4,737MT $787
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.