How much rates vary
Facilitymedian $832 · 10th to 90th $295 to $4,467Professionalmedian $355 · 10th to 90th $78 to $631
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 $134.90 Median $1,258.93 Typical High $10,715.19 | Facility | None | $134.90 | $1,258.93 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $302.00 Typical High $2,187.76 | Professional | None | $72.44 | $302.00 | $2,187.76 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $138.04 | Professional | None | $70.79 | $100.00 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $251.19 Typical High $562.34 | Professional | None | $75.86 | $251.19 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $371.54 Typical High $851.14 | Professional | 50 · Both sides | $112.20 | $371.54 | $851.14 |
CareSource Setting Facility Modifier None Typical Low $102.33 Median $537.03 Typical High $812.83 | Facility | None | $102.33 | $537.03 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $380.19 Median $398.11 Typical High $426.58 | Professional | None | $380.19 | $398.11 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $616.60 Typical High $1,659.59 | Facility | None | $489.78 | $616.60 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $323.59 Typical High $691.83 | Professional | None | $87.10 | $323.59 | $691.83 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $954.99 Typical High $1,737.80 | Facility | None | $512.86 | $954.99 | $1,737.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $87.10 Median $302.00 Typical High $676.08 | Professional | None | $87.10 | $302.00 | $676.08 |
Molina Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $602.56 | Professional | None | $331.13 | $446.68 | $602.56 |
SummaCare Setting Professional Modifier None Typical Low $74.13 Median $338.84 Typical High $446.68 | Professional | None | $74.13 | $338.84 | $446.68 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,311.31 | Facility | None | $363.08 | $691.83 | $3,311.31 |
United Setting Professional Modifier None Typical Low $81.28 Median $346.74 Typical High $741.31 | Professional | None | $81.28 | $346.74 | $741.31 |
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 $36.31 Median $151.36 Typical High $169.82 | Professional | 52 · Reduced service | $36.31 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $60.26 Typical High $67.61 | Professional | 53 · Discontinued | $14.45 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $229.09 Typical High $257.04 | Professional | 54 · Surgery only | $54.95 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $45.71 Typical High $51.29 | Professional | 55 · Aftercare only | $10.96 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $30.20 Typical High $33.88 | Professional | 56 · Pre-op care only | $7.24 | $30.20 | $33.88 |
Where Ohio sits
The same service costs 5.5 times more in Connecticut than in Montana. 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
CT $3,114MT $570
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.