How much rates vary
Facilitymedian $501 · 10th to 90th $87 to $10,233Professionalmedian $129 · 10th to 90th $48 to $257
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 $87.10 Median $416.87 Typical High $10,232.93 | Facility | None | $87.10 | $416.87 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $151.36 Typical High $478.63 | Professional | None | $47.86 | $151.36 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $147.91 | Professional | None | $50.12 | $69.18 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $16,595.87 Median $16,595.87 Typical High $18,620.87 | Facility | None | $16,595.87 | $16,595.87 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $48.98 Typical High $97.72 | Professional | None | $40.74 | $48.98 | $97.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $58.88 Median $74.13 Typical High $138.04 | Professional | 50 · Both sides | $58.88 | $74.13 | $138.04 |
Aultcare Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $53.70 | Professional | None | $48.98 | $48.98 | $53.70 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $234.42 | Professional | None | $138.04 | $151.36 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $147.91 Typical High $263.03 | Professional | None | $52.48 | $147.91 | $263.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $154.88 Median $288.40 Typical High $741.31 | Facility | None | $154.88 | $288.40 | $741.31 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $52.48 Median $147.91 Typical High $245.47 | Professional | None | $52.48 | $147.91 | $245.47 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $269.15 | Professional | None | $131.83 | $194.98 | $269.15 |
SummaCare Setting Professional Modifier None Typical Low $43.65 Median $131.83 Typical High $223.87 | Professional | None | $43.65 | $131.83 | $223.87 |
United Setting Facility Modifier None Typical Low $478.63 Median $1,445.44 Typical High $3,715.35 | Facility | None | $478.63 | $1,445.44 | $3,715.35 |
United Setting Professional Modifier None Typical Low $52.48 Median $141.25 Typical High $269.15 | Professional | None | $52.48 | $141.25 | $269.15 |
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 $23.99 Median $75.86 Typical High $97.72 | Professional | 52 · Reduced service | $23.99 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $30.20 Typical High $38.90 | Professional | 53 · Discontinued | $9.55 | $30.20 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $112.20 Typical High $144.54 | Professional | 54 · Surgery only | $36.31 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $22.39 Typical High $29.51 | Professional | 55 · Aftercare only | $7.24 | $22.39 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $15.14 Typical High $19.50 | Professional | 56 · Pre-op care only | $4.79 | $15.14 | $19.50 |
Where Ohio sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 33rd of 51
$135
AK $257VA $66.07
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.