How much rates vary
Facilitymedian $417 · 10th to 90th $48 to $3,548Professionalmedian $56 · 10th to 90th $39 to $95
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 $74.13 Median $208.93 Typical High $10,715.19 | Facility | None | $74.13 | $208.93 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $57.54 Typical High $123.03 | Professional | None | $37.15 | $57.54 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $66.07 | Professional | None | $63.10 | $63.10 | $66.07 |
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 $38.02 Median $52.48 Typical High $85.11 | Professional | None | $38.02 | $52.48 | $85.11 |
Aultcare Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $89.13 | Professional | None | $75.86 | $75.86 | $89.13 |
CareSource Setting Facility Modifier None Typical Low $36.31 Median $47.86 Typical High $50.12 | Facility | None | $36.31 | $47.86 | $50.12 |
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 $41.69 Median $75.86 Typical High $1,479.11 | Facility | None | $41.69 | $75.86 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $60.26 Typical High $100.00 | Professional | None | $41.69 | $60.26 | $100.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $41.69 Median $75.86 Typical High $1,479.11 | Facility | None | $41.69 | $75.86 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $41.69 Median $57.54 Typical High $95.50 | Professional | None | $41.69 | $57.54 | $95.50 |
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 $21.88 Median $22.91 Typical High $25.70 | Facility | None | $21.88 | $22.91 | $25.70 |
SummaCare Setting Professional Modifier None Typical Low $38.02 Median $54.95 Typical High $74.13 | Professional | None | $38.02 | $54.95 | $74.13 |
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 $30.20 Median $51.29 Typical High $91.20 | Professional | None | $30.20 | $51.29 | $91.20 |
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 $19.95 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $19.95 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $7.94 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $46.77 Typical High $46.77 | Professional | 54 · Surgery only | $29.51 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $6.03 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $3.98 | $6.17 | $6.17 |
Where Ohio sits
The same service costs 3.5 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· 44th of 51
$58.88
AK $178FL $51.29
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.