How much rates vary
Facilitymedian $204 · 10th to 90th $66 to $1,778Professionalmedian $85 · 10th to 90th $52 to $145
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 $85.11 Median $165.96 Typical High $281.84 | Facility | None | $85.11 | $165.96 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $181.97 | Professional | None | $60.26 | $85.11 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $104.71 | Professional | None | $91.20 | $91.20 | $104.71 |
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 $44.67 Median $56.23 Typical High $93.33 | Professional | None | $44.67 | $56.23 | $93.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $67.61 Median $85.11 Typical High $134.90 | Professional | 50 · Both sides | $67.61 | $85.11 | $134.90 |
Aultcare Setting Professional Modifier None Typical Low $67.61 Median $109.65 Typical High $114.82 | Professional | None | $67.61 | $109.65 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $57.54 Median $74.13 Typical High $77.62 | Facility | None | $57.54 | $74.13 | $77.62 |
CareSource Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $128.82 | Professional | None | $83.18 | $104.71 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $75.86 Typical High $144.54 | Facility | None | $58.88 | $75.86 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $83.18 Typical High $141.25 | Professional | None | $61.66 | $83.18 | $141.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $77.62 Typical High $398.11 | Facility | None | $58.88 | $77.62 | $398.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $61.66 Median $100.00 Typical High $165.96 | Professional | None | $61.66 | $100.00 | $165.96 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $158.49 | Professional | None | $79.43 | $104.71 | $158.49 |
SummaCare Setting Facility Modifier None Typical Low $35.48 Median $37.15 Typical High $41.69 | Facility | None | $35.48 | $37.15 | $41.69 |
SummaCare Setting Professional Modifier None Typical Low $58.88 Median $95.50 Typical High $125.89 | Professional | None | $58.88 | $95.50 | $125.89 |
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 $43.65 Median $70.79 Typical High $128.82 | Professional | None | $43.65 | $70.79 | $128.82 |
4 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 $30.20 Median $42.66 Typical High $44.67 | Professional | 52 · Reduced service | $30.20 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.98 Typical High $17.78 | Professional | 53 · Discontinued | $12.02 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.59 Typical High $13.18 | Professional | 55 · Aftercare only | $9.12 | $12.59 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.51 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.03 | $8.51 | $8.91 |
Where Ohio sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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· 38th of 51
$85.11
AK $257KY $69.18
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.