How much rates vary
Facilitymedian $871 · 10th to 90th $166 to $9,120Professionalmedian $263 · 10th to 90th $126 to $776
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 $213.80 Median $933.25 Typical High $12,302.69 | Facility | None | $213.80 | $933.25 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $1,513.56 | Professional | None | $114.82 | $208.93 | $1,513.56 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $251.19 | Professional | None | $194.98 | $251.19 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,174.90 Typical High $4,786.30 | Facility | None | $645.65 | $1,174.90 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $691.83 Typical High $977.24 | Professional | None | $147.91 | $691.83 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $1,047.13 Typical High $1,445.44 | Professional | 50 · Both sides | $218.78 | $1,047.13 | $1,445.44 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $151.36 Typical High $181.97 | Facility | None | $138.04 | $151.36 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $251.19 Typical High $3,388.44 | Facility | None | $141.25 | $251.19 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $457.09 | Professional | None | $125.89 | $213.80 | $457.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $141.25 Median $251.19 Typical High $3,388.44 | Facility | None | $141.25 | $251.19 | $3,388.44 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $446.68 | Professional | None | $125.89 | $213.80 | $446.68 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $331.13 | Professional | None | $186.21 | $245.47 | $331.13 |
SummaCare Setting Facility Modifier None Typical Low $75.86 Median $79.43 Typical High $91.20 | Facility | None | $75.86 | $79.43 | $91.20 |
SummaCare Setting Professional Modifier None Typical Low $109.65 Median $204.17 Typical High $257.04 | Professional | None | $109.65 | $204.17 | $257.04 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $128.82 Median $229.09 Typical High $724.44 | Professional | None | $128.82 | $229.09 | $724.44 |
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 $57.54 Median $104.71 Typical High $107.15 | Professional | 52 · Reduced service | $57.54 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $41.69 Typical High $43.65 | Professional | 53 · Discontinued | $22.91 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $154.88 Typical High $162.18 | Professional | 54 · Surgery only | $87.10 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $30.90 Typical High $32.36 | Professional | 55 · Aftercare only | $17.38 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $20.89 Typical High $21.38 | Professional | 56 · Pre-op care only | $11.48 | $20.89 | $21.38 |
Where Ohio sits
The same service costs 3.2 times more in Oklahoma than in Texas. 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· 21st of 51
$288
OK $692TX $214
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.