How much rates vary
Facilitymedian $219 · 10th to 90th $95 to $339Professionalmedian $107 · 10th to 90th $76 to $195
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 $97.72 Median $239.88 Typical High $338.84 | Facility | None | $97.72 | $239.88 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $169.82 | Professional | None | $72.44 | $95.50 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $138.04 | Professional | None | $79.43 | $117.49 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $91.20 Typical High $128.82 | Professional | None | $70.79 | $91.20 | $128.82 |
Aultcare Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $169.82 | Professional | None | $120.23 | $134.90 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $87.10 Median $134.90 Typical High $177.83 | Facility | None | $87.10 | $134.90 | $177.83 |
CareSource Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $181.97 | Professional | None | $114.82 | $123.03 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $162.18 | Professional | None | $89.13 | $114.82 | $162.18 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $269.15 | Professional | None | $91.20 | $141.25 | $269.15 |
Molina Setting Professional Modifier None Typical Low $45.71 Median $79.43 Typical High $147.91 | Professional | None | $45.71 | $79.43 | $147.91 |
SummaCare Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $128.82 | Professional | None | $81.28 | $102.33 | $128.82 |
United Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $147.91 | Professional | None | $72.44 | $97.72 | $147.91 |
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 Professional Modifier 52 · Reduced service Typical Low $36.31 Median $47.86 Typical High $53.70 | Professional | 52 · Reduced service | $36.31 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.45 Typical High $16.22 | Professional | 55 · Aftercare only | $10.96 | $14.45 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.55 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.24 | $9.55 | $10.96 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 24 · Unrelated visit after surgery | $81.28 | $81.28 | $81.28 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $104.71 Median $123.03 Typical High $147.91 | Professional | 25 · Same-day visit | $104.71 | $123.03 | $147.91 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $79.43 Median $79.43 Typical High $154.88 | Professional | GC · Resident with teaching physician | $79.43 | $79.43 | $154.88 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $83.18 Median $104.71 Typical High $123.03 | Professional | SA · Nurse practitioner | $83.18 | $104.71 | $123.03 |
Ambetter Setting Professional Modifier SB · Nurse midwife Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | SB · Nurse midwife | $100.00 | $100.00 | $100.00 |
Ambetter Setting Professional Modifier U1 · State-defined Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | U1 · State-defined | $95.50 | $95.50 | $95.50 |
Ambetter Setting Professional Modifier UD · State-defined Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | UD · State-defined | $104.71 | $104.71 | $104.71 |
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· 39th of 51
$107
AK $240DC $89.13
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.