How much rates vary
Facilitymedian $138 · 10th to 90th $81 to $309Professionalmedian $79 · 10th to 90th $42 to $158
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 $95.50 Median $218.78 Typical High $380.19 | Facility | None | $95.50 | $218.78 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $309.03 | Professional | None | $89.13 | $91.20 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $70.79 Typical High $74.13 | Professional | None | $39.81 | $70.79 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $131.83 Typical High $208.93 | Facility | None | $93.33 | $131.83 | $208.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $79.43 Typical High $147.91 | Professional | None | $57.54 | $79.43 | $147.91 |
Aultcare Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $91.20 | Professional | None | $79.43 | $79.43 | $91.20 |
CareSource Setting Facility Modifier None Typical Low $57.54 Median $89.13 Typical High $131.83 | Facility | None | $57.54 | $89.13 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $154.88 | Professional | None | $74.13 | $114.82 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $134.90 Typical High $467.74 | Facility | None | $75.86 | $134.90 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $79.43 | Professional | None | $60.26 | $60.26 | $79.43 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $57.54 Median $123.03 Typical High $323.59 | Facility | None | $57.54 | $123.03 | $323.59 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $31.62 Median $43.65 Typical High $60.26 | Professional | None | $31.62 | $43.65 | $60.26 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $138.04 | Professional | None | $63.10 | $81.28 | $138.04 |
SummaCare Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $138.04 | Professional | None | $74.13 | $114.82 | $138.04 |
United Setting Facility Modifier None Typical Low $40.74 Median $102.33 Typical High $169.82 | Facility | None | $40.74 | $102.33 | $169.82 |
United Setting Professional Modifier None Typical Low $33.88 Median $57.54 Typical High $162.18 | Professional | None | $33.88 | $57.54 | $162.18 |
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 $45.71 Median $85.11 Typical High $138.04 | Facility | 52 · Reduced service | $45.71 | $85.11 | $138.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.20 Median $33.88 Typical High $54.95 | Facility | 53 · Discontinued | $18.20 | $33.88 | $54.95 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $69.18 Median $125.89 Typical High $204.17 | Facility | 54 · Surgery only | $69.18 | $125.89 | $204.17 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.80 Median $25.12 Typical High $40.74 | Facility | 55 · Aftercare only | $13.80 | $25.12 | $40.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.12 Median $16.98 Typical High $27.54 | Facility | 56 · Pre-op care only | $9.12 | $16.98 | $27.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $45.71 Typical High $138.04 | Professional | 52 · Reduced service | $45.71 | $45.71 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $54.95 | Professional | 53 · Discontinued | $18.20 | $18.20 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $204.17 | Professional | 54 · Surgery only | $69.18 | $69.18 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $40.74 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $27.54 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $27.54 |
Where Ohio sits
The same service costs 4.9 times more in Alaska than in Georgia. 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· 29th of 51
$87.10
AK $224GA $45.71
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.