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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $7,943.28 | Professional | None | $151.36 | $151.36 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $67.61 Typical High $107.15 | Professional | None | $57.54 | $67.61 | $107.15 |
CareSource Setting Professional Modifier None Typical Low $194.98 Median $2,511.89 Typical High $4,466.84 | Professional | None | $194.98 | $2,511.89 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $691.83 Typical High $2,691.53 | Facility | None | $512.86 | $691.83 | $2,691.53 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $691.83 Typical High $2,691.53 | Facility | None | $512.86 | $691.83 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
United Setting Facility Modifier None Typical Low $97.72 Median $257.04 Typical High $2,398.83 | Facility | None | $97.72 | $257.04 | $2,398.83 |
United Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $407.38 | Professional | None | $190.55 | $234.42 | $407.38 |
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 $75.86 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 54 · Surgery only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.14 |
Where Ohio sits
The same service costs 18.6 times more in Texas 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· 48th of 51
$151
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.