How much rates vary
Facilitymedian $3,802 · 10th to 90th $646 to $12,589Professionalmedian $501 · 10th to 90th $295 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 $6,309.57 Median $10,232.93 Typical High $13,803.84 | Facility | None | $6,309.57 | $10,232.93 | $13,803.84 |
Aetna Setting Facility Modifier 26 · Professional part Typical Low $302.00 Median $831.76 Typical High $1,000.00 | Facility | 26 · Professional part | $302.00 | $831.76 | $1,000.00 |
Aetna Setting Professional Modifier None (both parts) Typical Low $6,606.93 Median $9,332.54 Typical High $12,589.25 | Professional | None (both parts) | $6,606.93 | $9,332.54 | $12,589.25 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $302.00 Median $302.00 Typical High $831.76 | Professional | 26 · Professional part | $302.00 | $302.00 | $831.76 |
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 $251.19 Median $295.12 Typical High $467.74 | Professional | 26 · Professional part | $251.19 | $295.12 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $79,432.82 | Facility | None | $346.74 | $346.74 | $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 $257.04 Median $257.04 Typical High $398.11 | Professional | None (both parts) | $257.04 | $257.04 | $398.11 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $302.00 Median $380.19 Typical High $660.69 | Professional | 26 · Professional part | $302.00 | $380.19 | $660.69 |
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 $398.11 Median $398.11 Typical High $398.11 | Professional | None (both parts) | $398.11 | $398.11 | $398.11 |
Medical Mutual of Ohio Setting Professional Modifier 26 · Professional part Typical Low $302.00 Median $380.19 Typical High $660.69 | Professional | 26 · Professional part | $302.00 | $380.19 | $660.69 |
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 $295.12 Median $309.03 Typical High $446.68 | Professional | 26 · Professional part | $295.12 | $309.03 | $446.68 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $8,709.64 | Facility | None | $851.14 | $2,630.27 | $8,709.64 |
United Setting Professional Modifier None (both parts) Typical Low $295.12 Median $398.11 Typical High $741.31 | Professional | None (both parts) | $295.12 | $398.11 | $741.31 |
United Setting Professional Modifier 26 · Professional part Typical Low $295.12 Median $398.11 Typical High $741.31 | Professional | 26 · Professional part | $295.12 | $398.11 | $741.31 |
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 $151.36 Median $151.36 Typical High $3,311.31 | Professional | 52 · Reduced service | $151.36 | $151.36 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $1,348.96 | Professional | 53 · Discontinued | $60.26 | $60.26 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $5,011.87 | Professional | 54 · Surgery only | $223.87 | $223.87 | $5,011.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $1,000.00 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $676.08 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $676.08 |
Where Ohio sits
The same service costs 23.4 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· 13th of 51
$2,188
CO $6,761KY $288
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.