How much rates vary
Facilitymedian $398 · 10th to 90th $34 to $3,548Professionalmedian $52 · 10th to 90th $34 to $91
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 $51.29 Median $147.91 Typical High $10,232.93 | Facility | None | $51.29 | $147.91 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $50.12 Typical High $104.71 | Professional | None | $33.88 | $50.12 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $61.66 Typical High $61.66 | Professional | None | $41.69 | $61.66 | $61.66 |
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 $26.30 Median $48.98 Typical High $75.86 | Professional | None | $26.30 | $48.98 | $75.86 |
Aultcare Setting Professional Modifier None Typical Low $41.69 Median $58.88 Typical High $58.88 | Professional | None | $41.69 | $58.88 | $58.88 |
CareSource Setting Facility Modifier None Typical Low $26.30 Median $33.88 Typical High $44.67 | Facility | None | $26.30 | $33.88 | $44.67 |
CareSource Setting Professional Modifier None Typical Low $48.98 Median $61.66 Typical High $75.86 | Professional | None | $48.98 | $61.66 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $51.29 Typical High $1,479.11 | Facility | None | $27.54 | $51.29 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $83.18 | Professional | None | $38.90 | $54.95 | $83.18 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $27.54 Median $66.07 Typical High $1,479.11 | Facility | None | $27.54 | $66.07 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $85.11 | Professional | None | $38.90 | $54.95 | $85.11 |
Molina Setting Professional Modifier None Typical Low $52.48 Median $67.61 Typical High $104.71 | Professional | None | $52.48 | $67.61 | $104.71 |
SummaCare Setting Facility Modifier None Typical Low $14.45 Median $15.14 Typical High $17.38 | Facility | None | $14.45 | $15.14 | $17.38 |
SummaCare Setting Professional Modifier None Typical Low $36.31 Median $50.12 Typical High $66.07 | Professional | None | $36.31 | $50.12 | $66.07 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $28.18 Median $44.67 Typical High $83.18 | Professional | None | $28.18 | $44.67 | $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 $17.78 Median $25.12 Typical High $26.92 | Professional | 52 · Reduced service | $17.78 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $10.00 Typical High $10.72 | Professional | 53 · Discontinued | $7.08 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $38.02 Typical High $40.74 | Professional | 54 · Surgery only | $26.92 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $7.59 Typical High $8.13 | Professional | 55 · Aftercare only | $5.37 | $7.59 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $5.01 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.55 | $5.01 | $5.37 |
Where Ohio sits
The same service costs 4.2 times more in Alaska 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· 39th of 51
$52.48
AK $186NY $44.67
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.