How much rates vary
Facilitymedian $1,122 · 10th to 90th $263 to $2,754Professionalmedian $69 · 10th to 90th $44 to $316
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 $1,047.13 Median $1,071.52 Typical High $1,412.54 | Facility | None | $1,047.13 | $1,071.52 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $51.29 Typical High $69.18 | Professional | None | $38.90 | $51.29 | $69.18 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $66.07 Typical High $97.72 | Professional | None | $54.95 | $66.07 | $97.72 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $54.95 Median $77.62 Typical High $91.20 | Professional | 25 · Same-day visit | $54.95 | $77.62 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $4,168.69 | Facility | None | $1,288.25 | $2,511.89 | $4,168.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $151.36 Typical High $316.23 | Professional | None | $64.57 | $151.36 | $316.23 |
CareSource Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $93.33 | Professional | None | $64.57 | $79.43 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,659.59 Typical High $1,659.59 | Facility | None | $549.54 | $1,659.59 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $72.44 Typical High $190.55 | Professional | None | $63.10 | $72.44 | $190.55 |
Hally Health Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $107.15 | Professional | None | $77.62 | $102.33 | $107.15 |
Health Alliance Plan Setting Facility Modifier None Typical Low $91.20 Median $954.99 Typical High $1,412.54 | Facility | None | $91.20 | $954.99 | $1,412.54 |
Health Alliance Plan Setting Facility Modifier 25 · Same-day visit Typical Low $741.31 Median $1,148.15 Typical High $2,884.03 | Facility | 25 · Same-day visit | $741.31 | $1,148.15 | $2,884.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $645.65 Median $912.01 Typical High $1,659.59 | Facility | None | $645.65 | $912.01 | $1,659.59 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $213.80 Median $954.99 Typical High $2,290.87 | Facility | None | $213.80 | $954.99 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $58.88 Median $77.62 Typical High $125.89 | Professional | None | $58.88 | $77.62 | $125.89 |
Priority Health Setting Facility Modifier None Typical Low $645.65 Median $1,258.93 Typical High $1,659.59 | Facility | None | $645.65 | $1,258.93 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $2,570.40 | Facility | None | $1,348.96 | $1,905.46 | $2,570.40 |
United Setting Professional Modifier None Typical Low $56.23 Median $67.61 Typical High $95.50 | Professional | None | $56.23 | $67.61 | $95.50 |
4 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 $25.70 Median $25.70 Typical High $31.62 | Professional | 52 · Reduced service | $25.70 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $9.55 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $6.31 |
Ambetter Setting Professional Modifier AQ · Shortage area physician Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | AQ · Shortage area physician | $66.07 | $66.07 | $66.07 |
Where Indiana sits
The same service costs 11.2 times more in California than in Idaho. 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.
Physician feeFacility fee
CA $2,527ID $226
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.