How much rates vary
Facilitymedian $3,388 · 10th to 90th $617 to $9,333Professionalmedian $2,570 · 10th to 90th $229 to $4,467
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 $416.87 Median $4,365.16 Typical High $10,964.78 | Facility | None | $416.87 | $4,365.16 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $2,454.71 Typical High $9,332.54 | Professional | None | $223.87 | $2,454.71 | $9,332.54 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $7,079.46 | Facility | None | $758.58 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $831.76 Typical High $3,801.89 | Professional | None | $218.78 | $831.76 | $3,801.89 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $4,073.80 Typical High $5,248.07 | Facility | None | $295.12 | $4,073.80 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $4,570.88 Typical High $6,918.31 | Facility | None | $549.54 | $4,570.88 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $2,454.71 Typical High $4,897.79 | Professional | None | $239.88 | $2,454.71 | $4,897.79 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $4,570.88 Typical High $6,918.31 | Facility | None | $549.54 | $4,570.88 | $6,918.31 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $239.88 Median $2,454.71 Typical High $4,786.30 | Professional | None | $239.88 | $2,454.71 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $2,454.71 Median $3,235.94 Typical High $4,365.16 | Professional | None | $2,454.71 | $3,235.94 | $4,365.16 |
SummaCare Setting Facility Modifier None Typical Low $2,238.72 Median $2,344.23 Typical High $2,630.27 | Facility | None | $2,238.72 | $2,344.23 | $2,630.27 |
SummaCare Setting Professional Modifier None Typical Low $213.80 Median $616.60 Typical High $3,311.31 | Professional | None | $213.80 | $616.60 | $3,311.31 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $251.19 Median $2,630.27 Typical High $5,623.41 | Professional | None | $251.19 | $2,630.27 | $5,623.41 |
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 $112.20 Median $1,230.27 Typical High $4,677.35 | Professional | 52 · Reduced service | $112.20 | $1,230.27 | $4,677.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $489.78 Typical High $1,862.09 | Professional | 53 · Discontinued | $44.67 | $489.78 | $1,862.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $1,819.70 Typical High $7,079.46 | Professional | 54 · Surgery only | $169.82 | $1,819.70 | $7,079.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $363.08 Typical High $1,412.54 | Professional | 55 · Aftercare only | $33.88 | $363.08 | $1,412.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $245.47 Typical High $933.25 | Professional | 56 · Pre-op care only | $22.39 | $245.47 | $933.25 |
Where Ohio sits
The same service costs 11.2 times more in Alaska than in Nebraska. 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· 27th of 51
$2,630
AK $5,248NE $468
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.