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 $2,137.96 Median $7,079.46 Typical High $12,022.64 | Facility | None | $2,137.96 | $7,079.46 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $7,762.47 | Professional | None | $758.58 | $758.58 | $7,762.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,238.72 Typical High $7,079.46 | Facility | None | $758.58 | $2,238.72 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,148.15 | Professional | None | $630.96 | $741.31 | $1,148.15 |
CareSource Setting Professional Modifier None Typical Low $1,000.00 Median $12,882.50 Typical High $22,387.21 | Professional | None | $1,000.00 | $12,882.50 | $22,387.21 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,801.89 Typical High $6,456.54 | Facility | None | $549.54 | $3,801.89 | $6,456.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $3,801.89 Typical High $6,025.60 | Facility | None | $549.54 | $3,801.89 | $6,025.60 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
SummaCare Setting Facility Modifier None Typical Low $2,089.30 Median $2,187.76 Typical High $2,454.71 | Facility | None | $2,089.30 | $2,187.76 | $2,454.71 |
SummaCare Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,258.93 | Professional | None | $977.24 | $977.24 | $1,258.93 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,120.11 | Facility | None | $851.14 | $2,818.38 | $9,120.11 |
United Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,659.59 | Professional | None | $691.83 | $831.76 | $1,659.59 |
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 $380.19 Median $380.19 Typical High $407.38 | Professional | 52 · Reduced service | $380.19 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $162.18 | Professional | 53 · Discontinued | $154.88 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $602.56 | Professional | 54 · Surgery only | $575.44 | $575.44 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $120.23 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $81.28 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $81.28 |
Where Ohio sits
The same service costs 5.1 times more in Texas than in Delaware. 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· 35th of 51
$891
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.