How much rates vary
Facilitymedian $468 · 10th to 90th $72 to $3,715Professionalmedian $120 · 10th to 90th $91 to $275
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 $251.19 Median $1,995.26 Typical High $10,964.78 | Facility | None | $251.19 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $112.20 Typical High $446.68 | Professional | None | $91.20 | $112.20 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $141.25 | Professional | None | $102.33 | $141.25 | $141.25 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $141.25 Median $213.80 Typical High $213.80 | Professional | 50 · Both sides | $141.25 | $213.80 | $213.80 |
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 $102.33 Median $186.21 Typical High $251.19 | Professional | None | $102.33 | $186.21 | $251.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $154.88 Median $275.42 Typical High $380.19 | Professional | 50 · Both sides | $154.88 | $275.42 | $380.19 |
Aultcare Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $147.91 | Professional | None | $128.82 | $128.82 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $56.23 Median $74.13 Typical High $112.20 | Facility | None | $56.23 | $74.13 | $112.20 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $104.71 Typical High $141.25 | Professional | None | $102.33 | $104.71 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $109.65 Typical High $1,479.11 | Facility | None | $63.10 | $109.65 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $269.15 | Professional | None | $77.62 | $107.15 | $269.15 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $63.10 Median $109.65 Typical High $1,479.11 | Facility | None | $63.10 | $109.65 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $309.03 | Professional | None | $91.20 | $125.89 | $309.03 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $151.36 | Professional | None | $79.43 | $100.00 | $151.36 |
SummaCare Setting Facility Modifier None Typical Low $66.07 Median $69.18 Typical High $79.43 | Facility | None | $66.07 | $69.18 | $79.43 |
SummaCare Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $134.90 | Professional | None | $77.62 | $109.65 | $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 $93.33 Median $138.04 Typical High $239.88 | Professional | None | $93.33 | $138.04 | $239.88 |
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 $45.71 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $45.71 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $18.20 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $85.11 Typical High $85.11 | Professional | 54 · Surgery only | $69.18 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $13.80 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $9.12 | $11.22 | $11.22 |
Where Ohio sits
The same service costs 3.7 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· 36th of 51
$135
AK $363FL $97.72
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.