How much rates vary
Facilitymedian $331 · 10th to 90th $56 to $3,715Professionalmedian $110 · 10th to 90th $68 to $182
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 $114.82 Median $331.13 Typical High $10,715.19 | Facility | None | $114.82 | $331.13 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $97.72 Typical High $323.59 | Professional | None | $61.66 | $97.72 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $144.54 | Professional | None | $75.86 | $104.71 | $144.54 |
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 $74.13 Median $100.00 Typical High $158.49 | Professional | None | $74.13 | $100.00 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $50.12 Median $64.57 Typical High $77.62 | Facility | None | $50.12 | $64.57 | $77.62 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $125.89 | Professional | None | $112.20 | $117.49 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $58.88 Typical High $109.65 | Facility | None | $48.98 | $58.88 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $104.71 Typical High $204.17 | Professional | None | $64.57 | $104.71 | $204.17 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $407.38 | Facility | None | $50.12 | $66.07 | $407.38 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $64.57 Median $104.71 Typical High $204.17 | Professional | None | $64.57 | $104.71 | $204.17 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $165.96 | Professional | None | $91.20 | $120.23 | $165.96 |
SummaCare Setting Facility Modifier None Typical Low $26.92 Median $28.18 Typical High $31.62 | Facility | None | $26.92 | $28.18 | $31.62 |
SummaCare Setting Professional Modifier None Typical Low $57.54 Median $97.72 Typical High $169.82 | Professional | None | $57.54 | $97.72 | $169.82 |
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 $67.61 Median $104.71 Typical High $181.97 | Professional | None | $67.61 | $104.71 | $181.97 |
10 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 $30.90 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $30.90 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $12.30 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $72.44 Typical High $72.44 | Professional | 54 · Surgery only | $46.77 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $9.33 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $9.77 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.17 | $9.77 | $9.77 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $42.66 Median $93.33 Typical High $93.33 | Professional | 51 · Multiple procedures | $42.66 | $93.33 | $93.33 |
Ambetter Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $21.38 | $21.38 | $21.38 |
Ambetter Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $95.50 | $95.50 | $95.50 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 59 · Distinct service | $112.20 | $112.20 | $112.20 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | GC · Resident with teaching physician | $64.57 | $64.57 | $64.57 |
Where Ohio sits
The same service costs 3.0 times more in Wisconsin 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· 34th of 51
$110
WI $282KY $93.33
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.