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 $3,890.45 Median $9,332.54 Typical High $13,803.84 | Facility | None | $3,890.45 | $9,332.54 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $11,220.18 | Professional | None | $363.08 | $363.08 | $11,220.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,715.35 Typical High $19,054.61 | Facility | None | $1,047.13 | $3,715.35 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $616.60 | Professional | None | $316.23 | $371.54 | $616.60 |
CareSource Setting Professional Modifier None Typical Low $478.63 Median $6,025.60 Typical High $10,715.19 | Professional | None | $478.63 | $6,025.60 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $6,760.83 Typical High $11,481.54 | Facility | None | $549.54 | $6,760.83 | $11,481.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $6,760.83 Typical High $10,715.19 | Facility | None | $549.54 | $6,760.83 | $10,715.19 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Facility Modifier None Typical Low $3,715.35 Median $3,890.45 Typical High $4,365.16 | Facility | None | $3,715.35 | $3,890.45 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,265.80 Typical High $14,454.40 | Facility | None | $1,071.52 | $4,265.80 | $14,454.40 |
United Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $1,122.02 | Professional | None | $52.48 | $74.13 | $1,122.02 |
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 $120.23 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $120.23 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $47.86 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $177.83 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $35.48 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $23.99 | $36.31 | $36.31 |
Where Ohio sits
The same service costs 93.3 times more in Oregon than in Vermont. 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· 34th of 51
$589
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.