How much rates vary
Facilitymedian $162 · 10th to 90th $60 to $1,622Professionalmedian $79 · 10th to 90th $42 to $138
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 $52.48 Median $131.83 Typical High $263.03 | Facility | None | $52.48 | $131.83 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $79.43 Typical High $169.82 | Professional | None | $40.74 | $79.43 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $107.15 | Professional | None | $57.54 | $57.54 | $107.15 |
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 $42.66 Median $53.70 Typical High $85.11 | Professional | None | $42.66 | $53.70 | $85.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $64.57 Median $81.28 Typical High $120.23 | Professional | 50 · Both sides | $64.57 | $81.28 | $120.23 |
Aultcare Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
CareSource Setting Facility Modifier None Typical Low $50.12 Median $51.29 Typical High $66.07 | Facility | None | $50.12 | $51.29 | $66.07 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $123.03 | Professional | None | $79.43 | $100.00 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $72.44 Typical High $141.25 | Facility | None | $57.54 | $72.44 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $79.43 Typical High $131.83 | Professional | None | $42.66 | $79.43 | $131.83 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $74.13 Typical High $354.81 | Facility | None | $58.88 | $74.13 | $354.81 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $42.66 Median $79.43 Typical High $131.83 | Professional | None | $42.66 | $79.43 | $131.83 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $154.88 | Professional | None | $79.43 | $100.00 | $154.88 |
SummaCare Setting Facility Modifier None Typical Low $33.88 Median $35.48 Typical High $40.74 | Facility | None | $33.88 | $35.48 | $40.74 |
SummaCare Setting Professional Modifier None Typical Low $38.90 Median $77.62 Typical High $112.20 | Professional | None | $38.90 | $77.62 | $112.20 |
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 $33.88 Median $66.07 Typical High $123.03 | Professional | None | $33.88 | $66.07 | $123.03 |
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 $20.42 Median $39.81 Typical High $41.69 | Professional | 52 · Reduced service | $20.42 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $15.85 Typical High $16.98 | Professional | 53 · Discontinued | $8.13 | $15.85 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $12.02 Typical High $12.59 | Professional | 55 · Aftercare only | $6.17 | $12.02 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $7.94 Typical High $8.32 | Professional | 56 · Pre-op care only | $4.07 | $7.94 | $8.32 |
Where Ohio sits
The same service costs 3.8 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· 36th of 51
$79.43
AK $214VA $56.23
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.