How much rates vary
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 $1,862.09 Median $4,570.88 Typical High $12,589.25 | Facility | None | $1,862.09 | $4,570.88 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $4,786.30 | Professional | None | $1,412.54 | $1,412.54 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $4,677.35 Typical High $21,877.62 | Facility | None | $1,445.44 | $4,677.35 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $1,047.13 | Professional | None | $537.03 | $630.96 | $1,047.13 |
CareSource Setting Professional Modifier None Typical Low $1,819.70 Median $23,442.29 Typical High $41,686.94 | Professional | None | $1,819.70 | $23,442.29 | $41,686.94 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $11,481.54 Typical High $18,620.87 | Facility | None | $549.54 | $11,481.54 | $18,620.87 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $11,481.54 Typical High $18,620.87 | Facility | None | $549.54 | $11,481.54 | $18,620.87 |
SummaCare Setting Facility Modifier None Typical Low $6,309.57 Median $6,606.93 Typical High $7,413.10 | Facility | None | $6,309.57 | $6,606.93 | $7,413.10 |
SummaCare Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,174.90 | Professional | None | $912.01 | $912.01 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $6,456.54 Typical High $23,442.29 | Facility | None | $1,258.93 | $6,456.54 | $23,442.29 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,949.84 | Professional | None | $912.01 | $1,348.96 | $1,949.84 |
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 $707.95 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $141.25 |
Where Ohio sits
The same service costs 6.9 times more in Arkansas than in Kentucky. 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· 45th of 51
$1,380
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.