How much rates vary
Facilitymedian $5,012 · 10th to 90th $661 to $13,490Professionalmedian $324 · 10th to 90th $195 to $10,965
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 $5,623.41 Median $10,232.93 Typical High $13,803.84 | Facility | None | $5,623.41 | $10,232.93 | $13,803.84 |
Aetna Setting Facility Modifier 26 · Professional part Typical Low $199.53 Median $363.08 Typical High $660.69 | Facility | 26 · Professional part | $199.53 | $363.08 | $660.69 |
Aetna Setting Professional Modifier None (both parts) Typical Low $891.25 Median $9,332.54 Typical High $12,589.25 | Professional | None (both parts) | $891.25 | $9,332.54 | $12,589.25 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $199.53 Median $199.53 Typical High $549.54 | Professional | 26 · Professional part | $199.53 | $199.53 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $10,715.19 | Facility | None | $630.96 | $1,698.24 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $208.93 Median $208.93 Typical High $338.84 | Professional | None (both parts) | $208.93 | $208.93 | $338.84 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $158.49 Median $186.21 Typical High $295.12 | Professional | 26 · Professional part | $158.49 | $186.21 | $295.12 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $79,432.82 | Facility | None | $229.09 | $229.09 | $79,432.82 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $446.68 Typical High $501.19 | Facility | None | $100.00 | $446.68 | $501.19 |
Cigna Setting Professional Modifier None (both parts) Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None (both parts) | $251.19 | $251.19 | $251.19 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $190.55 Median $239.88 Typical High $416.87 | Professional | 26 · Professional part | $190.55 | $239.88 | $416.87 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $100.00 Median $446.68 Typical High $501.19 | Facility | None | $100.00 | $446.68 | $501.19 |
Medical Mutual of Ohio Setting Professional Modifier None (both parts) Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None (both parts) | $251.19 | $251.19 | $251.19 |
Medical Mutual of Ohio Setting Professional Modifier 26 · Professional part Typical Low $190.55 Median $239.88 Typical High $416.87 | Professional | 26 · Professional part | $190.55 | $239.88 | $416.87 |
Molina Setting Professional Modifier None (both parts) Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None (both parts) | $30.20 | $30.20 | $30.20 |
SummaCare Setting Professional Modifier 26 · Professional part Typical Low $190.55 Median $199.53 Typical High $288.40 | Professional | 26 · Professional part | $190.55 | $199.53 | $288.40 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,265.80 Typical High $13,803.84 | Facility | None | $1,071.52 | $4,265.80 | $13,803.84 |
United Setting Professional Modifier None (both parts) Typical Low $194.98 Median $251.19 Typical High $489.78 | Professional | None (both parts) | $194.98 | $251.19 | $489.78 |
United Setting Professional Modifier 26 · Professional part Typical Low $194.98 Median $251.19 Typical High $489.78 | Professional | 26 · Professional part | $194.98 | $251.19 | $489.78 |
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 $97.72 Median $97.72 Typical High $446.68 | Professional | 52 · Reduced service | $97.72 | $97.72 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $177.83 | Professional | 53 · Discontinued | $39.81 | $39.81 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $660.69 | Professional | 54 · Surgery only | $147.91 | $147.91 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $131.83 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $89.13 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $89.13 |
Where Ohio sits
The same service costs 28.8 times more in Colorado than in Kentucky. 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· 23rd of 51
$1,820
CO $7,079KY $245
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.