How much rates vary
Facilitymedian $759 · 10th to 90th $347 to $4,074Professionalmedian $269 · 10th to 90th $151 to $447
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 $288.40 Median $954.99 Typical High $10,715.19 | Facility | None | $288.40 | $954.99 | $10,715.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $75.86 Median $218.78 Typical High $478.63 | Facility | 53 · Discontinued | $75.86 | $218.78 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $302.00 Typical High $537.03 | Professional | None | $151.36 | $302.00 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $75.86 Typical High $151.36 | Professional | 53 · Discontinued | $30.90 | $75.86 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $194.98 | Professional | None | $144.54 | $144.54 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $954.99 Typical High $3,467.37 | Facility | None | $389.05 | $954.99 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $269.15 Typical High $416.87 | Professional | None | $158.49 | $269.15 | $416.87 |
Anthem BCBS Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $147.91 Typical High $251.19 | Professional | 53 · Discontinued | $75.86 | $147.91 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $190.55 Median $467.74 Typical High $616.60 | Facility | None | $190.55 | $467.74 | $616.60 |
CareSource Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $181.97 | Professional | None | $162.18 | $162.18 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $549.54 Typical High $1,479.11 | Facility | None | $363.08 | $549.54 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $446.68 | Professional | None | $158.49 | $288.40 | $446.68 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $549.54 Typical High $1,479.11 | Facility | None | $389.05 | $549.54 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $436.52 | Professional | None | $158.49 | $288.40 | $436.52 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $281.84 Typical High $512.86 | Professional | None | $144.54 | $281.84 | $512.86 |
SummaCare Setting Facility Modifier None Typical Low $263.03 Median $275.42 Typical High $316.23 | Facility | None | $263.03 | $275.42 | $316.23 |
SummaCare Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $407.38 | Professional | None | $144.54 | $218.78 | $407.38 |
SummaCare Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $109.65 Typical High $204.17 | Professional | 53 · Discontinued | $72.44 | $109.65 | $204.17 |
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 $144.54 Median $251.19 Typical High $407.38 | Professional | None | $144.54 | $251.19 | $407.38 |
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 $75.86 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $75.86 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $229.09 Typical High $234.42 | Professional | 54 · Surgery only | $114.82 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $45.71 Typical High $46.77 | Professional | 55 · Aftercare only | $22.91 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $30.20 Typical High $30.90 | Professional | 56 · Pre-op care only | $15.14 | $30.20 | $30.90 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $125.89 Median $138.04 Typical High $138.04 | Professional | 33 · Preventive service | $125.89 | $138.04 | $138.04 |
Where Ohio sits
The same service costs 4.7 times more in Connecticut than in North Dakota. 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
CT $3,190ND $672
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.