How much rates vary
Facilitymedian $398 · 10th to 90th $45 to $3,388Professionalmedian $66 · 10th to 90th $41 to $112
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 $61.66 Median $162.18 Typical High $10,232.93 | Facility | None | $61.66 | $162.18 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $61.66 Typical High $134.90 | Professional | None | $43.65 | $61.66 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $36.31 Median $60.26 Typical High $81.28 | Professional | None | $36.31 | $60.26 | $81.28 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $63.10 Median $83.18 Typical High $112.20 | Professional | 50 · Both sides | $63.10 | $83.18 | $112.20 |
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 $40.74 Median $66.07 Typical High $107.15 | Professional | None | $40.74 | $66.07 | $107.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $57.54 Median $85.11 Typical High $151.36 | Professional | 50 · Both sides | $57.54 | $85.11 | $151.36 |
Aultcare Setting Professional Modifier None Typical Low $46.77 Median $79.43 Typical High $104.71 | Professional | None | $46.77 | $79.43 | $104.71 |
CareSource Setting Facility Modifier None Typical Low $32.36 Median $42.66 Typical High $56.23 | Facility | None | $32.36 | $42.66 | $56.23 |
CareSource Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $93.33 | Professional | None | $60.26 | $75.86 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $67.61 Typical High $1,479.11 | Facility | None | $38.02 | $67.61 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $61.66 Typical High $104.71 | Professional | None | $46.77 | $61.66 | $104.71 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $39.81 Median $389.05 Typical High $1,479.11 | Facility | None | $39.81 | $389.05 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $46.77 Median $77.62 Typical High $123.03 | Professional | None | $46.77 | $77.62 | $123.03 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $104.71 | Professional | None | $53.70 | $67.61 | $104.71 |
SummaCare Setting Facility Modifier None Typical Low $19.95 Median $20.89 Typical High $23.99 | Facility | None | $19.95 | $20.89 | $23.99 |
SummaCare Setting Professional Modifier None Typical Low $40.74 Median $69.18 Typical High $95.50 | Professional | None | $40.74 | $69.18 | $95.50 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $3,019.95 | Facility | None | $97.72 | $275.42 | $3,019.95 |
United Setting Professional Modifier None Typical Low $35.48 Median $57.54 Typical High $100.00 | Professional | None | $35.48 | $57.54 | $100.00 |
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 $21.88 Median $30.90 Typical High $32.36 | Professional | 52 · Reduced service | $21.88 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $12.59 Typical High $12.88 | Professional | 53 · Discontinued | $8.91 | $12.59 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $46.77 Typical High $48.98 | Professional | 54 · Surgery only | $33.11 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $9.33 Typical High $9.77 | Professional | 55 · Aftercare only | $6.61 | $9.33 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.17 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.37 | $6.17 | $6.46 |
Where Ohio sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 37th of 51
$66.07
AK $224FL $53.70
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.