How much rates vary
Facilitymedian $1,820 · 10th to 90th $724 to $8,913Professionalmedian $617 · 10th to 90th $81 to $977
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 $1,148.15 Median $5,128.61 Typical High $12,589.25 | Facility | None | $1,148.15 | $5,128.61 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $630.96 Typical High $3,467.37 | Professional | None | $616.60 | $630.96 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,238.72 Typical High $7,762.47 | Facility | None | $758.58 | $2,238.72 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,023.29 | Professional | None | $537.03 | $660.69 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,000.00 Typical High $1,513.56 | Professional | 50 · Both sides | $794.33 | $1,000.00 | $1,513.56 |
Aultcare Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $851.14 Median $891.25 Typical High $1,174.90 | Facility | None | $851.14 | $891.25 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,047.13 Typical High $2,951.21 | Facility | None | $741.31 | $1,047.13 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,258.93 | Professional | None | $676.08 | $891.25 | $1,258.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $741.31 Median $1,047.13 Typical High $2,951.21 | Facility | None | $741.31 | $1,047.13 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,258.93 | Professional | None | $676.08 | $891.25 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $549.54 Typical High $870.96 | Professional | None | $67.61 | $549.54 | $870.96 |
SummaCare Setting Facility Modifier None Typical Low $489.78 Median $512.86 Typical High $588.84 | Facility | None | $489.78 | $512.86 | $588.84 |
SummaCare Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $1,023.29 | Professional | None | $616.60 | $645.65 | $1,023.29 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $426.58 Median $724.44 Typical High $1,230.27 | Professional | None | $426.58 | $724.44 | $1,230.27 |
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 $309.03 Median $309.03 Typical High $1,258.93 | Professional | 52 · Reduced service | $309.03 | $309.03 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $512.86 | Professional | 53 · Discontinued | $123.03 | $123.03 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $1,905.46 | Professional | 54 · Surgery only | $467.74 | $467.74 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $380.19 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $257.04 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $1,778.28 |
Where Ohio sits
The same service costs 4.1 times more in Colorado than in Maryland. 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 $8,541MD $2,072
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.