How much rates vary
Facilitymedian $10,233 · 10th to 90th $69 to $13,804Professionalmedian $69 · 10th to 90th $46 to $115
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 $69.18 Median $10,232.93 Typical High $13,803.84 | Facility | None | $69.18 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None (both parts) Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | None (both parts) | $69.18 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 26 · Professional part | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | TC · Technical part | $41.69 | $41.69 | $41.69 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $41.69 Median $56.23 Typical High $95.50 | Professional | None (both parts) | $41.69 | $56.23 | $95.50 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $30.90 Median $38.02 Typical High $53.70 | Professional | 26 · Professional part | $30.90 | $38.02 | $53.70 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $17.38 Median $20.42 Typical High $30.20 | Professional | TC · Technical part | $17.38 | $20.42 | $30.20 |
CareSource Setting Professional Modifier None (both parts) Typical Low $91.20 Median $831.76 Typical High $2,041.74 | Professional | None (both parts) | $91.20 | $831.76 | $2,041.74 |
Cigna Setting Professional Modifier None (both parts) Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None (both parts) | $354.81 | $354.81 | $354.81 |
Medical Mutual of Ohio Setting Professional Modifier None (both parts) Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None (both parts) | $354.81 | $354.81 | $354.81 |
Molina Setting Professional Modifier None (both parts) Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None (both parts) | $39.81 | $50.12 | $60.26 |
SummaCare Setting Professional Modifier None (both parts) Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None (both parts) | $70.79 | $70.79 | $70.79 |
United Setting Facility Modifier None Typical Low $77.62 Median $89.13 Typical High $125.89 | Facility | None | $77.62 | $89.13 | $125.89 |
United Setting Professional Modifier None (both parts) Typical Low $66.07 Median $93.33 Typical High $144.54 | Professional | None (both parts) | $66.07 | $93.33 | $144.54 |
United Setting Professional Modifier 26 · Professional part Typical Low $25.70 Median $36.31 Typical High $60.26 | Professional | 26 · Professional part | $25.70 | $36.31 | $60.26 |
United Setting Professional Modifier TC · Technical part Typical Low $39.81 Median $56.23 Typical High $83.18 | Professional | TC · Technical part | $39.81 | $56.23 | $83.18 |
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 $34.67 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 54 · Surgery only | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $6.92 |
Where Ohio sits
The same service costs 4.4 times more in Texas than in New York. 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· 38th of 51
$69.18
TX $174NY $39.81
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.