How much rates vary
Facilitymedian $4,074 · 10th to 90th $794 to $11,482Professionalmedian $1,349 · 10th to 90th $145 to $2,754
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 $562.34 Median $3,235.94 Typical High $10,715.19 | Facility | None | $562.34 | $3,235.94 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $288.40 Typical High $2,454.71 | Professional | None | $128.82 | $288.40 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,981.07 Typical High $20,892.96 | Facility | None | $1,047.13 | $3,981.07 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $380.19 | Professional | None | $97.72 | $131.83 | $380.19 |
CareSource Setting Facility Modifier None Typical Low $398.11 Median $5,623.41 Typical High $7,413.10 | Facility | None | $398.11 | $5,623.41 | $7,413.10 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $6,165.95 Typical High $10,471.29 | Facility | None | $537.03 | $6,165.95 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $512.86 Typical High $2,691.53 | Professional | None | $302.00 | $512.86 | $2,691.53 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $6,165.95 Typical High $10,471.29 | Facility | None | $549.54 | $6,165.95 | $10,471.29 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $316.23 Median $512.86 Typical High $2,691.53 | Professional | None | $316.23 | $512.86 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $218.78 Median $1,862.09 Typical High $2,951.21 | Professional | None | $218.78 | $1,862.09 | $2,951.21 |
SummaCare Setting Facility Modifier None Typical Low $5,888.44 Median $6,309.57 Typical High $7,079.46 | Facility | None | $5,888.44 | $6,309.57 | $7,079.46 |
SummaCare Setting Professional Modifier None Typical Low $302.00 Median $660.69 Typical High $2,511.89 | Professional | None | $302.00 | $660.69 | $2,511.89 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,467.37 Typical High $12,022.64 | Facility | None | $912.01 | $3,467.37 | $12,022.64 |
United Setting Professional Modifier None Typical Low $151.36 Median $316.23 Typical High $2,398.83 | Professional | None | $151.36 | $316.23 | $2,398.83 |
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 $144.54 Median $891.25 Typical High $954.99 | Professional | 52 · Reduced service | $144.54 | $891.25 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $354.81 Typical High $380.19 | Professional | 53 · Discontinued | $57.54 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $1,348.96 Typical High $1,445.44 | Professional | 54 · Surgery only | $213.80 | $1,348.96 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $269.15 Typical High $288.40 | Professional | 55 · Aftercare only | $43.65 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $177.83 Typical High $190.55 | Professional | 56 · Pre-op care only | $28.84 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $1,258.93 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $199.53 | $1,258.93 | $1,348.96 |
Where Ohio sits
The same service costs 13.1 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 $15,603MT $1,192
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.