How much rates vary
Facilitymedian $977 · 10th to 90th $457 to $4,898Professionalmedian $617 · 10th to 90th $33 to $1,230
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 $1,000.00 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,000.00 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $870.96 Typical High $1,023.29 | Professional | None | $85.11 | $870.96 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $4,570.88 | Facility | None | $524.81 | $1,122.02 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $85.11 Typical High $912.01 | Professional | None | $30.90 | $85.11 | $912.01 |
CareSource Setting Facility Modifier None Typical Low $104.71 Median $616.60 Typical High $794.33 | Facility | None | $104.71 | $616.60 | $794.33 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $100.00 | Professional | None | $89.13 | $89.13 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $707.95 Typical High $1,479.11 | Facility | None | $398.11 | $707.95 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $263.03 Typical High $1,258.93 | Professional | None | $85.11 | $263.03 | $1,258.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $398.11 Median $707.95 Typical High $1,479.11 | Facility | None | $398.11 | $707.95 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $85.11 Median $269.15 Typical High $1,230.27 | Professional | None | $85.11 | $269.15 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,584.89 | Professional | None | $776.25 | $1,000.00 | $1,584.89 |
SummaCare Setting Facility Modifier None Typical Low $338.84 Median $354.81 Typical High $407.38 | Facility | None | $338.84 | $354.81 | $407.38 |
SummaCare Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $1,148.15 | Professional | None | $81.28 | $123.03 | $1,148.15 |
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 $70.79 Median $588.84 Typical High $1,148.15 | Professional | None | $70.79 | $588.84 | $1,148.15 |
6 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 $42.66 Median $436.52 Typical High $457.09 | Professional | 52 · Reduced service | $42.66 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $173.78 Typical High $181.97 | Professional | 53 · Discontinued | $16.98 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $660.69 Typical High $676.08 | Professional | 54 · Surgery only | $63.10 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $131.83 Typical High $138.04 | Professional | 55 · Aftercare only | $12.59 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $87.10 Typical High $91.20 | Professional | 56 · Pre-op care only | $8.51 | $87.10 | $91.20 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 51 · Multiple procedures | $77.62 | $77.62 | $77.62 |
Where Ohio sits
The same service costs 14.1 times more in Washington than in Kentucky. 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· 36th of 51
$646
WA $1,288KY $91.20
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.