How much rates vary
Facilitymedian $490 · 10th to 90th $95 to $4,169Professionalmedian $107 · 10th to 90th $85 to $186
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 $275.42 Median $380.19 Typical High $12,589.25 | Facility | None | $275.42 | $380.19 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $389.05 | Professional | None | $100.00 | $114.82 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $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 $72.44 Median $100.00 Typical High $154.88 | Professional | None | $72.44 | $100.00 | $154.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $109.65 Median $151.36 Typical High $229.09 | Professional | 50 · Both sides | $109.65 | $151.36 | $229.09 |
Aultcare Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $794.33 | Facility | None | $50.12 | $66.07 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $190.55 | Professional | None | $87.10 | $117.49 | $190.55 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $794.33 | Facility | None | $50.12 | $66.07 | $794.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $190.55 | Professional | None | $87.10 | $117.49 | $190.55 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $151.36 | Professional | None | $77.62 | $100.00 | $151.36 |
SummaCare Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $134.90 | Professional | None | $87.10 | $114.82 | $134.90 |
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 $91.20 Median $112.20 Typical High $186.21 | Professional | None | $91.20 | $112.20 | $186.21 |
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 $50.12 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $50.12 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $19.95 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $85.11 Typical High $85.11 | Professional | 54 · Surgery only | $75.86 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $15.14 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.00 | $11.48 | $11.48 |
Where Ohio sits
The same service costs 4.5 times more in Alaska than in Florida. 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· 45th of 51
$112
AK $407FL $91.20
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.