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 $512.86 Median $3,235.94 Typical High $12,589.25 | Facility | None | $512.86 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $2,630.27 | Professional | None | $64.57 | $95.50 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $190.55 | Professional | None | $83.18 | $123.03 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $123.03 Median $1,584.89 Typical High $2,754.23 | Professional | None | $123.03 | $1,584.89 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $69.18 Typical High $616.60 | Facility | None | $52.48 | $69.18 | $616.60 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $52.48 Median $66.07 Typical High $616.60 | Facility | None | $52.48 | $66.07 | $616.60 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $158.49 | Professional | None | $85.11 | $114.82 | $158.49 |
SummaCare Setting Facility Modifier None Typical Low $56.23 Median $58.88 Typical High $67.61 | Facility | None | $56.23 | $58.88 | $67.61 |
SummaCare Setting Professional Modifier None Typical Low $58.88 Median $95.50 Typical High $117.49 | Professional | None | $58.88 | $95.50 | $117.49 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $61.66 Median $97.72 Typical High $169.82 | Professional | None | $61.66 | $97.72 | $169.82 |
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 $32.36 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $32.36 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $12.88 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $70.79 Typical High $70.79 | Professional | 54 · Surgery only | $47.86 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $9.55 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.46 | $9.55 | $9.55 |
Where Ohio sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 27th of 51
$117
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.