How much rates vary
Facilitymedian $513 · 10th to 90th $59 to $3,715Professionalmedian $74 · 10th to 90th $37 to $135
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 $63.10 Median $204.17 Typical High $10,232.93 | Facility | None | $63.10 | $204.17 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $66.07 Typical High $151.36 | Professional | None | $37.15 | $66.07 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $26.30 Median $34.67 Typical High $70.79 | Professional | None | $26.30 | $34.67 | $70.79 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 50 · Both sides | $107.15 | $107.15 | $107.15 |
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 $47.86 Median $67.61 Typical High $100.00 | Professional | None | $47.86 | $67.61 | $100.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $70.79 Median $97.72 Typical High $141.25 | Professional | 50 · Both sides | $70.79 | $97.72 | $141.25 |
Aultcare Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $107.15 | Professional | None | $91.20 | $91.20 | $107.15 |
CareSource Setting Facility Modifier None Typical Low $43.65 Median $50.12 Typical High $57.54 | Facility | None | $43.65 | $50.12 | $57.54 |
CareSource Setting Professional Modifier None Typical Low $67.61 Median $85.11 Typical High $104.71 | Professional | None | $67.61 | $85.11 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $93.33 Typical High $1,479.11 | Facility | None | $52.48 | $93.33 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $81.28 Typical High $134.90 | Professional | None | $46.77 | $81.28 | $134.90 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $56.23 Median $398.11 Typical High $2,238.72 | Facility | None | $56.23 | $398.11 | $2,238.72 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $28.84 Median $54.95 Typical High $117.49 | Professional | None | $28.84 | $54.95 | $117.49 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $154.88 | Professional | None | $77.62 | $100.00 | $154.88 |
SummaCare Setting Facility Modifier None Typical Low $28.18 Median $29.51 Typical High $33.11 | Facility | None | $28.18 | $29.51 | $33.11 |
SummaCare Setting Professional Modifier None Typical Low $38.90 Median $75.86 Typical High $112.20 | Professional | None | $38.90 | $75.86 | $112.20 |
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 $34.67 Median $74.13 Typical High $134.90 | Professional | None | $34.67 | $74.13 | $134.90 |
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 $18.62 Median $32.36 Typical High $38.90 | Professional | 52 · Reduced service | $18.62 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $13.18 Typical High $15.49 | Professional | 53 · Discontinued | $7.41 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $48.98 Typical High $58.88 | Professional | 54 · Surgery only | $28.18 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $9.77 Typical High $11.75 | Professional | 55 · Aftercare only | $5.62 | $9.77 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $6.61 Typical High $7.76 | Professional | 56 · Pre-op care only | $3.72 | $6.61 | $7.76 |
Where Ohio sits
The same service costs 3.5 times more in Alaska than in Virginia. 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· 32nd of 51
$79.43
AK $204VA $58.88
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.