How much rates vary
Facilitymedian $490 · 10th to 90th $79 to $3,802Professionalmedian $126 · 10th to 90th $56 to $269
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 $102.33 Median $416.87 Typical High $10,232.93 | Facility | None | $102.33 | $416.87 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $147.91 Typical High $501.19 | Professional | None | $56.23 | $147.91 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $47.86 Median $58.88 Typical High $97.72 | Professional | None | $47.86 | $58.88 | $97.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $70.79 Median $87.10 Typical High $141.25 | Professional | 50 · Both sides | $70.79 | $87.10 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $69.18 Median $537.03 Typical High $812.83 | Facility | None | $69.18 | $537.03 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $190.55 | Professional | None | $169.82 | $177.83 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $794.33 | Facility | None | $50.12 | $66.07 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $141.25 Typical High $245.47 | Professional | None | $58.88 | $141.25 | $245.47 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $81.28 Typical High $954.99 | Facility | None | $50.12 | $81.28 | $954.99 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $58.88 Median $141.25 Typical High $245.47 | Professional | None | $58.88 | $141.25 | $245.47 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $275.42 | Professional | None | $147.91 | $204.17 | $275.42 |
SummaCare Setting Professional Modifier None Typical Low $51.29 Median $125.89 Typical High $218.78 | Professional | None | $51.29 | $125.89 | $218.78 |
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 $54.95 Median $100.00 Typical High $257.04 | Professional | None | $54.95 | $100.00 | $257.04 |
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 $28.18 Median $74.13 Typical High $75.86 | Professional | 52 · Reduced service | $28.18 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $30.20 Typical High $30.90 | Professional | 53 · Discontinued | $11.22 | $30.20 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $112.20 Typical High $114.82 | Professional | 54 · Surgery only | $42.66 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $22.39 Typical High $22.91 | Professional | 55 · Aftercare only | $8.51 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $14.79 Typical High $15.14 | Professional | 56 · Pre-op care only | $5.62 | $14.79 | $15.14 |
Where Ohio sits
The same service costs 4.0 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· 22nd of 51
$141
AK $316KY $79.43
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.