How much rates vary
Facilitymedian $224 · 10th to 90th $138 to $302Professionalmedian $229 · 10th to 90th $155 to $380
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 $138.04 Median $223.87 Typical High $302.00 | Facility | None | $138.04 | $223.87 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $407.38 | Professional | None | $123.03 | $177.83 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $446.68 | Professional | None | $186.21 | $186.21 | $446.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $371.54 | Professional | None | $199.53 | $239.88 | $371.54 |
Aultcare Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $204.17 | Professional | None | $186.21 | $186.21 | $204.17 |
CareSource Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $316.23 | Professional | None | $190.55 | $263.03 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $407.38 | Professional | None | $194.98 | $213.80 | $407.38 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $169.82 Median $295.12 Typical High $389.05 | Professional | None | $169.82 | $295.12 | $389.05 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $275.42 | Professional | None | $141.25 | $204.17 | $275.42 |
Optum Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $269.15 | Professional | None | $208.93 | $208.93 | $269.15 |
SummaCare Setting Professional Modifier None Typical Low $194.98 Median $204.17 Typical High $407.38 | Professional | None | $194.98 | $204.17 | $407.38 |
United Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $380.19 | Professional | None | $186.21 | $223.87 | $380.19 |
8 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 $81.28 Median $81.28 Typical High $199.53 | Facility | 52 · Reduced service | $81.28 | $81.28 | $199.53 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $60.26 | Facility | 55 · Aftercare only | $24.55 | $24.55 | $60.26 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $40.74 | Facility | 56 · Pre-op care only | $16.22 | $16.22 | $40.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $81.28 Typical High $204.17 | Professional | 52 · Reduced service | $81.28 | $81.28 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $61.66 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $40.74 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $40.74 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $186.21 Median $186.21 Typical High $263.03 | Professional | FS · Shared visit | $186.21 | $186.21 | $263.03 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $245.47 Median $263.03 Typical High $389.05 | Professional | GC · Resident with teaching physician | $245.47 | $263.03 | $389.05 |
Where Ohio sits
The same service costs 2.4 times more in Alaska than in Utah. 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
$229
AK $407UT $170
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.