How much rates vary
Facilitymedian $1,047 · 10th to 90th $380 to $4,786Professionalmedian $129 · 10th to 90th $98 to $240
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 $281.84 Median $2,691.53 Typical High $10,964.78 | Facility | None | $281.84 | $2,691.53 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $2,344.23 | Professional | None | $102.33 | $141.25 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,148.15 Typical High $4,466.84 | Facility | None | $524.81 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $181.97 | Professional | None | $95.50 | $123.03 | $181.97 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $141.25 Median $186.21 Typical High $275.42 | Professional | 50 · Both sides | $141.25 | $186.21 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $123.03 Median $1,000.00 Typical High $1,288.25 | Facility | None | $123.03 | $1,000.00 | $1,288.25 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,148.15 Typical High $1,995.26 | Facility | None | $489.78 | $1,148.15 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $239.88 | Professional | None | $87.10 | $134.90 | $239.88 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,148.15 Typical High $1,995.26 | Facility | None | $512.86 | $1,148.15 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $239.88 | Professional | None | $87.10 | $134.90 | $239.88 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $199.53 | Professional | None | $107.15 | $134.90 | $199.53 |
SummaCare Setting Facility Modifier None Typical Low $562.34 Median $588.84 Typical High $660.69 | Facility | None | $562.34 | $588.84 | $660.69 |
SummaCare Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $165.96 | Professional | None | $87.10 | $141.25 | $165.96 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,388.44 | Facility | None | $363.08 | $691.83 | $3,388.44 |
United Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $223.87 | Professional | None | $93.33 | $131.83 | $223.87 |
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 $51.29 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $51.29 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $20.42 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $107.15 Typical High $107.15 | Professional | 54 · Surgery only | $75.86 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $15.14 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.23 | $14.13 | $14.13 |
Where Ohio sits
The same service costs 10.9 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 $3,950MT $363
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.