How much rates vary
Facilitymedian $708 · 10th to 90th $105 to $4,786Professionalmedian $148 · 10th to 90th $85 to $263
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 $147.91 Median $457.09 Typical High $10,715.19 | Facility | None | $147.91 | $457.09 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $501.19 | Professional | None | $81.28 | $134.90 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $79.43 Typical High $79.43 | Professional | None | $40.74 | $79.43 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $138.04 Typical High $213.80 | Professional | None | $87.10 | $138.04 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $85.11 Median $112.20 Typical High $114.82 | Facility | None | $85.11 | $112.20 | $114.82 |
CareSource Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $199.53 | Professional | None | $162.18 | $162.18 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $162.18 Typical High $1,479.11 | Facility | None | $91.20 | $162.18 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $131.83 Typical High $234.42 | Professional | None | $81.28 | $131.83 | $234.42 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $91.20 Median $173.78 Typical High $1,659.59 | Facility | None | $91.20 | $173.78 | $1,659.59 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $81.28 Median $131.83 Typical High $229.09 | Professional | None | $81.28 | $131.83 | $229.09 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $263.03 | Professional | None | $144.54 | $190.55 | $263.03 |
SummaCare Setting Facility Modifier None Typical Low $48.98 Median $51.29 Typical High $57.54 | Facility | None | $48.98 | $51.29 | $57.54 |
SummaCare Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $251.19 | Professional | None | $87.10 | $134.90 | $251.19 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $263.03 | Professional | None | $89.13 | $141.25 | $263.03 |
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 $40.74 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $40.74 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $16.22 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $102.33 Typical High $102.33 | Professional | 54 · Surgery only | $60.26 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $12.30 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $8.13 | $13.49 | $13.49 |
Where Ohio sits
The same service costs 3.2 times more in Alaska than in New Jersey. 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· 35th of 51
$155
AK $407NJ $129
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.