How much rates vary
Facilitymedian $741 · 10th to 90th $324 to $4,074Professionalmedian $102 · 10th to 90th $66 to $224
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 $223.87 Median $2,630.27 Typical High $12,022.64 | Facility | None | $223.87 | $2,630.27 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $2,630.27 | Professional | None | $69.18 | $69.18 | $2,630.27 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $851.14 Typical High $3,388.44 | Facility | None | $389.05 | $851.14 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $147.91 Typical High $223.87 | Professional | None | $81.28 | $147.91 | $223.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $120.23 Median $218.78 Typical High $338.84 | Professional | 50 · Both sides | $120.23 | $218.78 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $588.84 Typical High $758.58 | Facility | None | $95.50 | $588.84 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $660.69 Typical High $1,479.11 | Facility | None | $389.05 | $660.69 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $154.88 | Professional | None | $70.79 | $85.11 | $154.88 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $660.69 Typical High $1,479.11 | Facility | None | $389.05 | $660.69 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $165.96 | Professional | None | $70.79 | $85.11 | $165.96 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $74.13 Typical High $112.20 | Professional | None | $57.54 | $74.13 | $112.20 |
SummaCare Setting Facility Modifier None Typical Low $316.23 Median $331.13 Typical High $380.19 | Facility | None | $316.23 | $331.13 | $380.19 |
SummaCare Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $97.72 | Professional | None | $67.61 | $75.86 | $97.72 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,311.31 | Facility | None | $363.08 | $691.83 | $3,311.31 |
United Setting Professional Modifier None Typical Low $39.81 Median $95.50 Typical High $234.42 | Professional | None | $39.81 | $95.50 | $234.42 |
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 $34.67 Median $34.67 Typical High $562.34 | Professional | 52 · Reduced service | $34.67 | $34.67 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $223.87 | Professional | 53 · Discontinued | $13.80 | $13.80 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $51.29 Typical High $831.76 | Professional | 54 · Surgery only | $51.29 | $51.29 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $165.96 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $112.20 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $112.20 |
Where Ohio sits
The same service costs 12.2 times more in Connecticut than in Montana. 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 $2,815MT $231
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.