How much rates vary
Facilitymedian $550 · 10th to 90th $7 to $9,120Professionalmedian $6 · 10th to 90th $2 to $13
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 $3.24 Median $18.62 Typical High $10,715.19 | Facility | None | $3.24 | $18.62 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1.74 Median $5.62 Typical High $18.20 | Professional | None | $1.74 | $5.62 | $18.20 |
Ambetter Setting Professional Modifier None Typical Low $4.27 Median $5.01 Typical High $9.12 | Professional | None | $4.27 | $5.01 | $9.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $2,511.89 Typical High $18,620.87 | Facility | None | $549.54 | $2,511.89 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.04 Median $6.31 Typical High $13.18 | Professional | None | $2.04 | $6.31 | $13.18 |
Aultcare Setting Professional Modifier None Typical Low $6.17 Median $7.08 Typical High $7.41 | Professional | None | $6.17 | $7.08 | $7.41 |
CareSource Setting Facility Modifier None Typical Low $2.45 Median $537.03 Typical High $812.83 | Facility | None | $2.45 | $537.03 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $8.13 | Professional | None | $6.61 | $6.61 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $851.14 Typical High $2,691.53 | Facility | None | $50.12 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $4.79 Typical High $11.48 | Professional | None | $1.74 | $4.79 | $11.48 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $575.44 Typical High $2,691.53 | Facility | None | $50.12 | $575.44 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.82 Median $5.62 Typical High $12.59 | Professional | None | $1.82 | $5.62 | $12.59 |
Molina Setting Professional Modifier None Typical Low $1.95 Median $2.29 Typical High $6.03 | Professional | None | $1.95 | $2.29 | $6.03 |
SummaCare Setting Professional Modifier None Typical Low $1.74 Median $5.37 Typical High $9.55 | Professional | None | $1.74 | $5.37 | $9.55 |
United Setting Facility Modifier None Typical Low $97.72 Median $257.04 Typical High $2,398.83 | Facility | None | $97.72 | $257.04 | $2,398.83 |
United Setting Professional Modifier None Typical Low $2.04 Median $5.25 Typical High $10.23 | Professional | None | $2.04 | $5.25 | $10.23 |
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 $0.87 Median $2.82 Typical High $2.82 | Professional | 52 · Reduced service | $0.87 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.35 Median $1.12 Typical High $1.12 | Professional | 53 · Discontinued | $0.35 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.32 Median $4.17 Typical High $4.17 | Professional | 54 · Surgery only | $1.32 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.83 Typical High $0.83 | Professional | 55 · Aftercare only | $0.26 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.56 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.17 | $0.56 | $0.56 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $5.62 Median $7.08 Typical High $7.08 | Professional | 59 · Distinct service | $5.62 | $7.08 | $7.08 |
Where Ohio sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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· 40th of 51
$5.89
AK $12.88NE $4.37
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.