How much rates vary
Facilitymedian $1,380 · 10th to 90th $457 to $6,026Professionalmedian $427 · 10th to 90th $49 to $708
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 $831.76 Median $1,995.26 Typical High $10,964.78 | Facility | None | $831.76 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $1,862.09 | Professional | None | $302.00 | $426.58 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $1,548.82 Typical High $7,585.78 | Facility | None | $549.54 | $1,548.82 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $478.63 | Professional | None | $245.47 | $302.00 | $478.63 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $457.09 Typical High $707.95 | Professional | 50 · Both sides | $371.54 | $457.09 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $398.11 Median $1,174.90 Typical High $1,513.56 | Facility | None | $398.11 | $1,174.90 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $1,995.26 | Facility | None | $363.08 | $1,318.26 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $870.96 | Professional | None | $323.59 | $457.09 | $870.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $1,318.26 Typical High $1,905.46 | Facility | None | $389.05 | $1,318.26 | $1,905.46 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $912.01 | Professional | None | $323.59 | $457.09 | $912.01 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $457.09 Typical High $676.08 | Professional | None | $38.02 | $457.09 | $676.08 |
SummaCare Setting Facility Modifier None Typical Low $645.65 Median $676.08 Typical High $758.58 | Facility | None | $645.65 | $676.08 | $758.58 |
SummaCare Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $602.56 | Professional | None | $302.00 | $457.09 | $602.56 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,786.30 | Facility | None | $501.19 | $977.24 | $4,786.30 |
United Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $831.76 | Professional | None | $302.00 | $446.68 | $831.76 |
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 $151.36 Median $213.80 Typical High $223.87 | Professional | 52 · Reduced service | $151.36 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $85.11 Typical High $89.13 | Professional | 53 · Discontinued | $60.26 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $316.23 Typical High $331.13 | Professional | 54 · Surgery only | $223.87 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $63.10 Typical High $66.07 | Professional | 55 · Aftercare only | $44.67 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $42.66 Typical High $44.67 | Professional | 56 · Pre-op care only | $30.20 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $295.12 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $208.93 | $295.12 | $309.03 |
Where Ohio sits
The same service costs 5.0 times more in Colorado than in Delaware. 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 $5,773DE $1,161
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.