How much rates vary
Facilitymedian $457 · 10th to 90th $29 to $3,715Professionalmedian $69 · 10th to 90th $47 to $141
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 $128.82 Median $1,995.26 Typical High $10,964.78 | Facility | None | $128.82 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $323.59 | Professional | None | $46.77 | $51.29 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $3,311.31 | Facility | None | $363.08 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $128.82 | Professional | None | $52.48 | $81.28 | $128.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $77.62 Median $123.03 Typical High $186.21 | Professional | 50 · Both sides | $77.62 | $123.03 | $186.21 |
Aultcare Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
CareSource Setting Facility Modifier None Typical Low $22.39 Median $29.51 Typical High $56.23 | Facility | None | $22.39 | $29.51 | $56.23 |
CareSource Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $45.71 Typical High $1,479.11 | Facility | None | $25.12 | $45.71 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $61.66 Typical High $141.25 | Professional | None | $38.90 | $61.66 | $141.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $25.12 Median $43.65 Typical High $1,479.11 | Facility | None | $25.12 | $43.65 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $40.74 Median $64.57 Typical High $158.49 | Professional | None | $40.74 | $64.57 | $158.49 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $67.61 Typical High $102.33 | Professional | None | $48.98 | $67.61 | $102.33 |
SummaCare Setting Facility Modifier None Typical Low $13.18 Median $13.80 Typical High $15.49 | Facility | None | $13.18 | $13.80 | $15.49 |
SummaCare Setting Professional Modifier None Typical Low $38.90 Median $52.48 Typical High $81.28 | Professional | None | $38.90 | $52.48 | $81.28 |
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 $50.12 Median $70.79 Typical High $114.82 | Professional | None | $50.12 | $70.79 | $114.82 |
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 $23.44 Median $25.70 Typical High $26.30 | Professional | 52 · Reduced service | $23.44 | $25.70 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.23 Typical High $10.47 | Professional | 53 · Discontinued | $9.33 | $10.23 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $38.90 Typical High $39.81 | Professional | 54 · Surgery only | $35.48 | $38.90 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.76 Typical High $7.94 | Professional | 55 · Aftercare only | $7.08 | $7.76 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.13 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.68 | $5.13 | $5.25 |
Where Ohio sits
The same service costs 3.6 times more in Wyoming 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· 30th of 51
$75.86
WY $191FL $52.48
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.