How much rates vary
Facilitymedian $263 · 10th to 90th $115 to $407Professionalmedian $135 · 10th to 90th $98 to $219
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 $114.82 Median $295.12 Typical High $407.38 | Facility | None | $114.82 | $295.12 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $204.17 | Professional | None | $89.13 | $114.82 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $177.83 | Professional | None | $100.00 | $147.91 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $173.78 | Professional | None | $100.00 | $125.89 | $173.78 |
Aultcare Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $275.42 | Professional | None | $165.96 | $165.96 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $107.15 Median $158.49 Typical High $204.17 | Facility | None | $107.15 | $158.49 | $204.17 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $147.91 Typical High $218.78 | Professional | None | $138.04 | $147.91 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $194.98 | Professional | None | $109.65 | $138.04 | $194.98 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $281.84 | Professional | None | $107.15 | $165.96 | $281.84 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $104.71 Typical High $158.49 | Professional | None | $58.88 | $104.71 | $158.49 |
Optum Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $169.82 | Professional | None | $147.91 | $147.91 | $169.82 |
SummaCare Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $158.49 | Professional | None | $100.00 | $131.83 | $158.49 |
United Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $177.83 | Professional | None | $89.13 | $123.03 | $177.83 |
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 Professional Modifier 52 · Reduced service Typical Low $44.67 Median $57.54 Typical High $66.07 | Professional | 52 · Reduced service | $44.67 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $17.38 Typical High $19.95 | Professional | 55 · Aftercare only | $13.18 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $11.48 Typical High $13.18 | Professional | 56 · Pre-op care only | $8.91 | $11.48 | $13.18 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $138.04 Median $147.91 Typical High $177.83 | Professional | 25 · Same-day visit | $138.04 | $147.91 | $177.83 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $97.72 Median $97.72 Typical High $169.82 | Professional | GC · Resident with teaching physician | $97.72 | $97.72 | $169.82 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | SA · Nurse practitioner | $125.89 | $125.89 | $125.89 |
Ambetter Setting Professional Modifier SB · Nurse midwife Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | SB · Nurse midwife | $144.54 | $144.54 | $144.54 |
Ambetter Setting Professional Modifier UD · State-defined Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | UD · State-defined | $125.89 | $125.89 | $125.89 |
Where Ohio sits
The same service costs 2.7 times more in Alaska than in Washington, DC. 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· 33rd of 51
$135
AK $295DC $110
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.