How much rates vary
Facilitymedian $417 · 10th to 90th $76 to $4,169Professionalmedian $117 · 10th to 90th $89 to $209
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 $165.96 Median $407.38 Typical High $10,715.19 | Facility | None | $165.96 | $407.38 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $407.38 | Professional | None | $89.13 | $120.23 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $251.19 | Professional | None | $120.23 | $186.21 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $169.82 | Professional | None | $79.43 | $107.15 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $64.57 Median $83.18 Typical High $112.20 | Facility | None | $64.57 | $83.18 | $112.20 |
CareSource Setting Professional Modifier None Typical Low $141.25 Median $147.91 Typical High $158.49 | Professional | None | $141.25 | $147.91 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $117.49 Typical High $1,479.11 | Facility | None | $67.61 | $117.49 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $234.42 | Professional | None | $91.20 | $131.83 | $234.42 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $67.61 Median $123.03 Typical High $1,479.11 | Facility | None | $67.61 | $123.03 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $239.88 | Professional | None | $91.20 | $131.83 | $239.88 |
Molina Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $165.96 | Professional | None | $93.33 | $120.23 | $165.96 |
SummaCare Setting Facility Modifier None Typical Low $35.48 Median $37.15 Typical High $41.69 | Facility | None | $35.48 | $37.15 | $41.69 |
SummaCare Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $162.18 | Professional | None | $85.11 | $125.89 | $162.18 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $234.42 | Professional | None | $89.13 | $125.89 | $234.42 |
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 $43.65 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $43.65 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $17.78 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $91.20 Typical High $91.20 | Professional | 54 · Surgery only | $66.07 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $13.18 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.91 | $12.02 | $12.02 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $109.65 Median $109.65 Typical High $112.20 | Professional | GC · Resident with teaching physician | $109.65 | $109.65 | $112.20 |
Where Ohio sits
The same service costs 3.7 times more in Alaska 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· 43rd of 51
$120
AK $372KY $100
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.