How much rates vary
Facilitymedian $191 · 10th to 90th $102 to $372Professionalmedian $145 · 10th to 90th $98 to $257
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 $104.71 Median $199.53 Typical High $407.38 | Facility | None | $104.71 | $199.53 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $194.98 | Professional | None | $77.62 | $109.65 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $208.93 | Professional | None | $102.33 | $144.54 | $208.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $177.83 | Professional | None | $95.50 | $120.23 | $177.83 |
Aultcare Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $234.42 | Professional | None | $131.83 | $169.82 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $245.47 | Professional | None | $154.88 | $165.96 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $128.82 Typical High $181.97 | Facility | None | $89.13 | $128.82 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $218.78 | Professional | None | $117.49 | $147.91 | $218.78 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $89.13 Median $128.82 Typical High $181.97 | Facility | None | $89.13 | $128.82 | $181.97 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $309.03 | Professional | None | $120.23 | $204.17 | $309.03 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $245.47 | Professional | None | $102.33 | $162.18 | $245.47 |
Optum Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $186.21 | Professional | None | $141.25 | $165.96 | $186.21 |
SummaCare Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $223.87 | Professional | None | $120.23 | $138.04 | $223.87 |
United Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $199.53 | Professional | None | $102.33 | $134.90 | $199.53 |
21 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 Facility Modifier 52 · Reduced service Typical Low $52.48 Median $64.57 Typical High $75.86 | Facility | 52 · Reduced service | $52.48 | $64.57 | $75.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.49 Median $19.50 Typical High $22.39 | Facility | 55 · Aftercare only | $15.49 | $19.50 | $22.39 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.88 Typical High $15.14 | Facility | 56 · Pre-op care only | $10.47 | $12.88 | $15.14 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $104.71 Median $128.82 Typical High $134.90 | Facility | AF · Specialist physician | $104.71 | $128.82 | $134.90 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $77.62 Median $97.72 Typical High $100.00 | Facility | HO · Master's level | $77.62 | $97.72 | $100.00 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $89.13 Median $109.65 Typical High $112.20 | Facility | TD · Registered nurse | $89.13 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $64.57 Typical High $69.18 | Professional | 52 · Reduced service | $52.48 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.50 Typical High $20.42 | Professional | 55 · Aftercare only | $15.49 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.88 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.47 | $12.88 | $13.80 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $104.71 Median $128.82 Typical High $199.53 | Professional | AF · Specialist physician | $104.71 | $128.82 | $199.53 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $77.62 Median $97.72 Typical High $151.36 | Professional | HO · Master's level | $77.62 | $97.72 | $151.36 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $89.13 Median $109.65 Typical High $169.82 | Professional | TD · Registered nurse | $89.13 | $109.65 | $169.82 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 24 · Unrelated visit after surgery | $269.15 | $269.15 | $269.15 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $114.82 Median $165.96 Typical High $204.17 | Professional | 25 · Same-day visit | $114.82 | $165.96 | $204.17 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $131.83 Median $169.82 Typical High $223.87 | Professional | 57 · Decision for surgery | $131.83 | $169.82 | $223.87 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $123.03 Median $138.04 Typical High $138.04 | Professional | 93 · Audio-only telehealth | $123.03 | $138.04 | $138.04 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $151.36 Median $162.18 Typical High $239.88 | Professional | FS · Shared visit | $151.36 | $162.18 | $239.88 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $114.82 Median $144.54 Typical High $239.88 | Professional | GC · Resident with teaching physician | $114.82 | $144.54 | $239.88 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $97.72 Median $109.65 Typical High $151.36 | Professional | SA · Nurse practitioner | $97.72 | $109.65 | $151.36 |
Ambetter Setting Professional Modifier TH · Pregnancy care Typical Low $112.20 Median $123.03 Typical High $123.03 | Professional | TH · Pregnancy care | $112.20 | $123.03 | $123.03 |
Ambetter Setting Professional Modifier UD · State-defined Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | UD · State-defined | $173.78 | $173.78 | $173.78 |
Where Ohio sits
The same service costs 2.3 times more in Alaska than in Alabama. 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
$145
AK $263AL $115
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.