How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,000 to $12,589Professionalmedian $1,698 · 10th to 90th $347 to $3,388
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 $741.31 Median $4,265.80 Typical High $10,964.78 | Facility | None | $741.31 | $4,265.80 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $1,949.84 Typical High $5,495.41 | Professional | None | $407.38 | $1,949.84 | $5,495.41 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $457.09 | Professional | None | $257.04 | $257.04 | $457.09 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $691.83 Typical High $1,023.29 | Professional | 50 · Both sides | $478.63 | $691.83 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $3,890.45 Typical High $20,417.38 | Facility | None | $1,862.09 | $3,890.45 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $1,230.27 Typical High $2,691.53 | Professional | None | $346.74 | $1,230.27 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $1,862.09 Typical High $3,981.07 | Professional | 50 · Both sides | $524.81 | $1,862.09 | $3,981.07 |
Aultcare Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $660.69 | Professional | None | $602.56 | $602.56 | $660.69 |
CareSource Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,737.80 | $1,905.46 | $2,951.21 |
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 $354.81 Median $1,122.02 Typical High $3,162.28 | Professional | None | $354.81 | $1,122.02 | $3,162.28 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $3,388.44 Median $5,888.44 Typical High $17,378.01 | Facility | None | $3,388.44 | $5,888.44 | $17,378.01 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $354.81 Median $758.58 Typical High $2,951.21 | Professional | None | $354.81 | $758.58 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $1,819.70 Median $2,691.53 Typical High $3,801.89 | Professional | None | $1,819.70 | $2,691.53 | $3,801.89 |
SummaCare Setting Professional Modifier None Typical Low $346.74 Median $2,238.72 Typical High $2,951.21 | Professional | None | $346.74 | $2,238.72 | $2,951.21 |
United Setting Facility Modifier None Typical Low $5,248.07 Median $9,549.93 Typical High $15,488.17 | Facility | None | $5,248.07 | $9,549.93 | $15,488.17 |
United Setting Professional Modifier None Typical Low $380.19 Median $1,698.24 Typical High $3,311.31 | Professional | None | $380.19 | $1,698.24 | $3,311.31 |
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 $204.17 Median $954.99 Typical High $1,174.90 | Professional | 52 · Reduced service | $204.17 | $954.99 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $380.19 Typical High $467.74 | Professional | 53 · Discontinued | $81.28 | $380.19 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $1,445.44 Typical High $1,778.28 | Professional | 54 · Surgery only | $309.03 | $1,445.44 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $288.40 Typical High $354.81 | Professional | 55 · Aftercare only | $61.66 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $190.55 Typical High $234.42 | Professional | 56 · Pre-op care only | $40.74 | $190.55 | $234.42 |
Where Ohio sits
The same service costs 6.3 times more in Washington than in Maryland. 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· 30th of 51
$1,698
WA $3,236MD $513
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.