How much rates vary
Facilitymedian $4,266 · 10th to 90th $832 to $12,303Professionalmedian $457 · 10th to 90th $282 to $10,965
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 $6,309.57 Median $10,232.93 Typical High $13,803.84 | Facility | None | $6,309.57 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None (both parts) Typical Low $5,623.41 Median $9,332.54 Typical High $12,589.25 | Professional | None (both parts) | $5,623.41 | $9,332.54 | $12,589.25 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 26 · Professional part | $269.15 | $269.15 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $407.38 Median $407.38 Typical High $630.96 | Professional | None (both parts) | $407.38 | $407.38 | $630.96 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $229.09 Median $269.15 Typical High $407.38 | Professional | 26 · Professional part | $229.09 | $269.15 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $79,432.82 | Facility | None | $309.03 | $309.03 | $79,432.82 |
Cigna Setting Professional Modifier None (both parts) Typical Low $234.42 Median $234.42 Typical High $363.08 | Professional | None (both parts) | $234.42 | $234.42 | $363.08 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $269.15 Median $346.74 Typical High $602.56 | Professional | 26 · Professional part | $269.15 | $346.74 | $602.56 |
Medical Mutual of Ohio Setting Professional Modifier None (both parts) Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None (both parts) | $363.08 | $363.08 | $363.08 |
Medical Mutual of Ohio Setting Professional Modifier 26 · Professional part Typical Low $269.15 Median $346.74 Typical High $602.56 | Professional | 26 · Professional part | $269.15 | $346.74 | $602.56 |
Molina Setting Professional Modifier None (both parts) Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None (both parts) | $30.20 | $30.20 | $30.20 |
SummaCare Setting Professional Modifier 26 · Professional part Typical Low $257.04 Median $269.15 Typical High $389.05 | Professional | 26 · Professional part | $257.04 | $269.15 | $389.05 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $8,709.64 | Facility | None | $851.14 | $2,630.27 | $8,709.64 |
United Setting Professional Modifier None (both parts) Typical Low $269.15 Median $354.81 Typical High $660.69 | Professional | None (both parts) | $269.15 | $354.81 | $660.69 |
United Setting Professional Modifier 26 · Professional part Typical Low $269.15 Median $354.81 Typical High $660.69 | Professional | 26 · Professional part | $269.15 | $354.81 | $660.69 |
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 $134.90 Median $134.90 Typical High $3,311.31 | Professional | 52 · Reduced service | $134.90 | $134.90 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $1,348.96 | Professional | 53 · Discontinued | $54.95 | $54.95 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $5,011.87 | Professional | 54 · Surgery only | $204.17 | $204.17 | $5,011.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $1,000.00 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $676.08 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $676.08 |
Where Ohio sits
The same service costs 19.5 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.
Ohio· 15th of 51
$2,399
CO $6,761MD $347
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.