How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,000 to $12,589Professionalmedian $1,738 · 10th to 90th $347 to $3,311
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 $4,466.84 Typical High $10,964.78 | Facility | None | $741.31 | $4,466.84 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $1,905.46 Typical High $5,754.40 | Professional | None | $407.38 | $1,905.46 | $5,754.40 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $501.19 | Professional | None | $213.80 | $338.84 | $501.19 |
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 $1,258.93 Typical High $2,630.27 | Professional | None | $346.74 | $1,258.93 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $1,905.46 Typical High $3,981.07 | Professional | 50 · Both sides | $524.81 | $1,905.46 | $3,981.07 |
Aultcare Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
CareSource Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,698.24 | $1,862.09 | $2,884.03 |
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 $346.74 Median $1,122.02 Typical High $3,162.28 | Professional | None | $346.74 | $1,122.02 | $3,162.28 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $3,801.89 Median $5,248.07 Typical High $14,454.40 | Facility | None | $3,801.89 | $5,248.07 | $14,454.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $346.74 Median $562.34 Typical High $2,754.23 | Professional | None | $346.74 | $562.34 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $1,778.28 Median $2,630.27 Typical High $3,715.35 | Professional | None | $1,778.28 | $2,630.27 | $3,715.35 |
SummaCare Setting Professional Modifier None Typical Low $338.84 Median $2,238.72 Typical High $2,884.03 | Professional | None | $338.84 | $2,238.72 | $2,884.03 |
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 $371.54 Median $1,698.24 Typical High $3,235.94 | Professional | None | $371.54 | $1,698.24 | $3,235.94 |
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 $933.25 Typical High $1,148.15 | Professional | 52 · Reduced service | $204.17 | $933.25 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $371.54 Typical High $457.09 | Professional | 53 · Discontinued | $81.28 | $371.54 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $1,412.54 Typical High $1,698.24 | Professional | 54 · Surgery only | $302.00 | $1,412.54 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $281.84 Typical High $338.84 | Professional | 55 · Aftercare only | $60.26 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $186.21 Typical High $229.09 | Professional | 56 · Pre-op care only | $40.74 | $186.21 | $229.09 |
Where Ohio sits
The same service costs 6.2 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
$1,738
WA $3,162MD $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.