How much rates vary
Facilitymedian $257 · 10th to 90th $148 to $501Professionalmedian $148 · 10th to 90th $135 to $204
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 $165.96 Median $407.38 Typical High $1,148.15 | Facility | None | $165.96 | $407.38 | $1,148.15 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $407.38 | Professional | None | $147.91 | $147.91 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $147.91 Median $239.88 Typical High $446.68 | Facility | None | $147.91 | $239.88 | $446.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $213.80 | Professional | None | $147.91 | $147.91 | $213.80 |
Aultcare Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Aultcare Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $302.00 | Professional | None | $147.91 | $147.91 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $138.04 | Professional | None | $107.15 | $107.15 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $323.59 Typical High $489.78 | Facility | None | $162.18 | $323.59 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $190.55 | Professional | None | $147.91 | $147.91 | $190.55 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $162.18 Median $323.59 Typical High $426.58 | Facility | None | $162.18 | $323.59 | $426.58 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $190.55 | Professional | None | $147.91 | $147.91 | $190.55 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $204.17 | Professional | None | $134.90 | $162.18 | $204.17 |
SummaCare Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $181.97 | Professional | None | $147.91 | $154.88 | $181.97 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
United Setting Professional Modifier None Typical Low $125.89 Median $144.54 Typical High $154.88 | Professional | None | $125.89 | $144.54 | $154.88 |
5 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 $74.13 Median $74.13 Typical High $81.28 | Professional | 52 · Reduced service | $74.13 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $33.11 | Professional | 53 · Discontinued | $29.51 | $29.51 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $24.55 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $16.60 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $16.60 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $120.23 Median $190.55 Typical High $190.55 | Professional | JZ · No drug discarded | $120.23 | $190.55 | $190.55 |
Where Ohio sits
The same service costs 2.4 times more in Wyoming than in New York. 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· 28th of 51
$148
WY $355NY $148
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.