How much rates vary
Facilitymedian $1,380 · 10th to 90th $525 to $6,026Professionalmedian $1,318 · 10th to 90th $155 to $2,344
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 $457.09 Median $3,890.45 Typical High $10,964.78 | Facility | None | $457.09 | $3,890.45 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $1,412.54 Typical High $4,786.30 | Professional | None | $165.96 | $1,412.54 | $4,786.30 |
Ambetter Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $1,071.52 Typical High $1,995.26 | Professional | None | $134.90 | $1,071.52 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $204.17 Median $1,445.44 Typical High $2,951.21 | Professional | 50 · Both sides | $204.17 | $1,445.44 | $2,951.21 |
CareSource Setting Facility Modifier None Typical Low $186.21 Median $954.99 Typical High $1,230.27 | Facility | None | $186.21 | $954.99 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,258.93 Typical High $6,025.60 | Facility | None | $549.54 | $1,258.93 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $457.09 Typical High $2,290.87 | Professional | None | $158.49 | $457.09 | $2,290.87 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $1,258.93 Typical High $6,025.60 | Facility | None | $549.54 | $1,258.93 | $6,025.60 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $158.49 Median $478.63 Typical High $2,187.76 | Professional | None | $158.49 | $478.63 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,258.93 | $1,513.56 | $1,995.26 |
SummaCare Setting Facility Modifier None Typical Low $575.44 Median $616.60 Typical High $691.83 | Facility | None | $575.44 | $616.60 | $691.83 |
SummaCare Setting Professional Modifier None Typical Low $138.04 Median $1,288.25 Typical High $1,949.84 | Professional | None | $138.04 | $1,288.25 | $1,949.84 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $169.82 Median $1,348.96 Typical High $2,951.21 | Professional | None | $169.82 | $1,348.96 | $2,951.21 |
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 $83.18 Median $707.95 Typical High $891.25 | Professional | 52 · Reduced service | $83.18 | $707.95 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $281.84 Typical High $354.81 | Professional | 53 · Discontinued | $33.11 | $281.84 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $1,047.13 Typical High $1,348.96 | Professional | 54 · Surgery only | $125.89 | $1,047.13 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $208.93 Typical High $269.15 | Professional | 55 · Aftercare only | $25.12 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $141.25 Typical High $177.83 | Professional | 56 · Pre-op care only | $16.60 | $141.25 | $177.83 |
Where Ohio sits
The same service costs 8.5 times more in Wisconsin than in Nebraska. 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· 32nd of 51
$1,318
WI $2,291NE $269
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.