How much rates vary
Facilitymedian $1,820 · 10th to 90th $575 to $5,754Professionalmedian $1,072 · 10th to 90th $251 to $1,820
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 $467.74 Median $2,951.21 Typical High $10,715.19 | Facility | None | $467.74 | $2,951.21 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $1,047.13 Typical High $3,548.13 | Professional | None | $251.19 | $1,047.13 | $3,548.13 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
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 $295.12 Median $1,071.52 Typical High $1,659.59 | Professional | None | $295.12 | $1,071.52 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $1,621.81 Typical High $2,454.71 | Professional | 50 · Both sides | $446.68 | $1,621.81 | $2,454.71 |
CareSource Setting Facility Modifier None Typical Low $309.03 Median $1,584.89 Typical High $2,089.30 | Facility | None | $309.03 | $1,584.89 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $4,677.35 | Facility | None | $588.84 | $1,862.09 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $758.58 Typical High $1,621.81 | Professional | None | $251.19 | $758.58 | $1,621.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $4,677.35 | Facility | None | $588.84 | $1,862.09 | $4,677.35 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $251.19 Median $758.58 Typical High $1,621.81 | Professional | None | $251.19 | $758.58 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,318.26 | $1,819.70 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,047.13 | Facility | None | $891.25 | $933.25 | $1,047.13 |
SummaCare Setting Professional Modifier None Typical Low $229.09 Median $1,047.13 Typical High $1,380.38 | Professional | None | $229.09 | $1,047.13 | $1,380.38 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $269.15 Median $912.01 Typical High $1,905.46 | Professional | None | $269.15 | $912.01 | $1,905.46 |
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 $123.03 Median $524.81 Typical High $562.34 | Professional | 52 · Reduced service | $123.03 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $213.80 Typical High $223.87 | Professional | 53 · Discontinued | $50.12 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $794.33 Typical High $851.14 | Professional | 54 · Surgery only | $186.21 | $794.33 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $158.49 Typical High $169.82 | Professional | 55 · Aftercare only | $37.15 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $104.71 Typical High $112.20 | Professional | 56 · Pre-op care only | $25.12 | $104.71 | $112.20 |
Where Ohio sits
The same service costs 3.2 times more in Oklahoma 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.
Physician feeFacility fee
OK $6,075KY $1,891
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.