How much rates vary
Facilitymedian $1,000 · 10th to 90th $132 to $9,333Professionalmedian $575 · 10th to 90th $129 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 $416.87 Median $1,995.26 Typical High $10,715.19 | Facility | None | $416.87 | $1,995.26 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $616.60 Typical High $2,511.89 | Professional | None | $158.49 | $616.60 | $2,511.89 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $10,715.19 Typical High $18,620.87 | Facility | None | $2,238.72 | $10,715.19 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $416.87 Typical High $870.96 | Professional | None | $114.82 | $416.87 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $691.83 Typical High $2,691.53 | Facility | None | $512.86 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $436.52 Typical High $977.24 | Professional | None | $151.36 | $436.52 | $977.24 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $691.83 Typical High $2,691.53 | Facility | None | $512.86 | $691.83 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $151.36 Median $457.09 Typical High $954.99 | Professional | None | $151.36 | $457.09 | $954.99 |
Molina Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $812.83 | Professional | None | $512.86 | $630.96 | $812.83 |
SummaCare Setting Professional Modifier None Typical Low $131.83 Median $562.34 Typical High $851.14 | Professional | None | $131.83 | $562.34 | $851.14 |
United Setting Facility Modifier None Typical Low $97.72 Median $257.04 Typical High $2,398.83 | Facility | None | $97.72 | $257.04 | $2,398.83 |
United Setting Professional Modifier None Typical Low $154.88 Median $602.56 Typical High $1,230.27 | Professional | None | $154.88 | $602.56 | $1,230.27 |
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 $79.43 Median $309.03 Typical High $398.11 | Professional | 52 · Reduced service | $79.43 | $309.03 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $123.03 Typical High $158.49 | Professional | 53 · Discontinued | $31.62 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $457.09 Typical High $602.56 | Professional | 54 · Surgery only | $120.23 | $457.09 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $91.20 Typical High $120.23 | Professional | 55 · Aftercare only | $23.99 | $91.20 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $61.66 Typical High $79.43 | Professional | 56 · Pre-op care only | $15.85 | $61.66 | $79.43 |
Where Ohio sits
The same service costs 17.4 times more in Alabama than in Montana. 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 $9,157MT $526
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.