How much rates vary
Facilitymedian $302 · 10th to 90th $117 to $457Professionalmedian $148 · 10th to 90th $100 to $263
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 $117.49 Median $302.00 Typical High $457.09 | Facility | None | $117.49 | $302.00 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $302.00 | Professional | None | $89.13 | $134.90 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $186.21 | Professional | None | $114.82 | $134.90 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $190.55 | Professional | None | $107.15 | $131.83 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $208.93 | Professional | None | $128.82 | $173.78 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $302.00 | Professional | None | $144.54 | $158.49 | $302.00 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $263.03 | Professional | None | $114.82 | $162.18 | $263.03 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $141.25 Typical High $208.93 | Professional | None | $77.62 | $141.25 | $208.93 |
Optum Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
SummaCare Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $269.15 | Professional | None | $141.25 | $162.18 | $269.15 |
United Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $281.84 | Professional | None | $134.90 | $169.82 | $281.84 |
10 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 $58.88 Median $58.88 Typical High $213.80 | Facility | 52 · Reduced service | $58.88 | $58.88 | $213.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $64.57 | Facility | 55 · Aftercare only | $17.78 | $17.78 | $64.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $42.66 | Facility | 56 · Pre-op care only | $11.75 | $11.75 | $42.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $58.88 Typical High $213.80 | Professional | 52 · Reduced service | $58.88 | $58.88 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $64.57 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $43.65 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $43.65 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $131.83 Median $186.21 Typical High $186.21 | Professional | 25 · Same-day visit | $131.83 | $186.21 | $186.21 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | FS · Shared visit | $208.93 | $208.93 | $208.93 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $134.90 Median $173.78 Typical High $288.40 | Professional | GC · Resident with teaching physician | $134.90 | $173.78 | $288.40 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $114.82 Median $158.49 Typical High $158.49 | Professional | SA · Nurse practitioner | $114.82 | $158.49 | $158.49 |
Where Ohio sits
The same service costs 2.4 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· 41st of 51
$151
AK $288AL $120
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.