How much rates vary
Facilitymedian $955 · 10th to 90th $468 to $4,677Professionalmedian $537 · 10th to 90th $148 to $1,047
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 $338.84 Median $2,041.74 Typical High $10,715.19 | Facility | None | $338.84 | $2,041.74 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $616.60 Typical High $1,737.80 | Professional | None | $181.97 | $616.60 | $1,737.80 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,047.13 Typical High $4,570.88 | Facility | None | $524.81 | $1,047.13 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $436.52 Typical High $831.76 | Professional | None | $147.91 | $436.52 | $831.76 |
Aultcare Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $204.17 Median $512.86 Typical High $660.69 | Facility | None | $204.17 | $512.86 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $616.60 Typical High $1,148.15 | Facility | None | $501.19 | $616.60 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $489.78 Typical High $977.24 | Professional | None | $173.78 | $489.78 | $977.24 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $616.60 Typical High $1,148.15 | Facility | None | $501.19 | $616.60 | $1,148.15 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $173.78 Median $588.84 Typical High $954.99 | Professional | None | $173.78 | $588.84 | $954.99 |
Molina Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,148.15 | Professional | None | $602.56 | $812.83 | $1,148.15 |
SummaCare Setting Facility Modifier None Typical Low $288.40 Median $302.00 Typical High $346.74 | Facility | None | $288.40 | $302.00 | $346.74 |
SummaCare Setting Professional Modifier None Typical Low $151.36 Median $436.52 Typical High $870.96 | Professional | None | $151.36 | $436.52 | $870.96 |
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 $173.78 Median $575.44 Typical High $1,096.48 | Professional | None | $173.78 | $575.44 | $1,096.48 |
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 $91.20 Median $323.59 Typical High $407.38 | Professional | 52 · Reduced service | $91.20 | $323.59 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $128.82 Typical High $162.18 | Professional | 53 · Discontinued | $36.31 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $489.78 Typical High $616.60 | Professional | 54 · Surgery only | $138.04 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $97.72 Typical High $123.03 | Professional | 55 · Aftercare only | $27.54 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $64.57 Typical High $81.28 | Professional | 56 · Pre-op care only | $18.20 | $64.57 | $81.28 |
Where Ohio sits
The same service costs 5.2 times more in Wisconsin than in Hawaii. 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· 37th of 51
$562
WI $1,148HI $219
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.