How much rates vary
Facilitymedian $2,692 · 10th to 90th $589 to $12,589Professionalmedian $813 · 10th to 90th $617 to $1,738
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 $2,238.72 Median $9,332.54 Typical High $12,589.25 | Facility | None | $2,238.72 | $9,332.54 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,318.26 Typical High $10,232.93 | Professional | None | $851.14 | $1,318.26 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,715.35 Typical High $19,054.61 | Facility | None | $1,047.13 | $3,715.35 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,230.27 | Professional | None | $645.65 | $812.83 | $1,230.27 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,862.09 | Professional | None | $676.08 | $954.99 | $1,862.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $691.83 Median $954.99 Typical High $1,862.09 | Professional | None | $691.83 | $954.99 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $870.96 | Professional | None | $575.44 | $691.83 | $870.96 |
SummaCare Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,202.26 | Professional | None | $630.96 | $741.31 | $1,202.26 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,511.89 Typical High $8,511.38 | Facility | None | $831.76 | $2,511.89 | $8,511.38 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $2,344.23 | Professional | None | $812.83 | $1,148.15 | $2,344.23 |
6 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 $426.58 Median $426.58 Typical High $1,023.29 | Professional | 52 · Reduced service | $426.58 | $426.58 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $407.38 | Professional | 53 · Discontinued | $169.82 | $169.82 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $1,548.82 | Professional | 54 · Surgery only | $645.65 | $645.65 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $309.03 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $204.17 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $204.17 |
Ambetter Setting Professional Modifier Q0 · Research study, investigational Typical Low $812.83 Median $933.25 Typical High $933.25 | Professional | Q0 · Research study, investigational | $812.83 | $933.25 | $933.25 |
Where Ohio sits
The same service costs 8.4 times more in Alabama 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.
Physician feeFacility fee
AL $15,863KY $1,884
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.