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 $2,454.71 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,454.71 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $7,762.47 | Professional | None | $371.54 | $371.54 | $7,762.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $7,079.46 | Facility | None | $758.58 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,230.27 | $1,949.84 |
CareSource Setting Professional Modifier None Typical Low $426.58 Median $5,495.41 Typical High $9,549.93 | Professional | None | $426.58 | $5,495.41 | $9,549.93 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $630.96 Typical High $2,691.53 | Facility | None | $501.19 | $630.96 | $2,691.53 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $691.83 Typical High $2,691.53 | Facility | None | $501.19 | $691.83 | $2,691.53 |
SummaCare Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,202.26 | Professional | None | $912.01 | $912.01 | $1,202.26 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,511.89 Typical High $8,511.38 | Facility | None | $831.76 | $2,511.89 | $8,511.38 |
United Setting Professional Modifier None Typical Low $269.15 Median $870.96 Typical High $1,548.82 | Professional | None | $269.15 | $870.96 | $1,548.82 |
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 $186.21 Median $186.21 Typical High $288.40 | Professional | 52 · Reduced service | $186.21 | $186.21 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $114.82 | Professional | 53 · Discontinued | $74.13 | $74.13 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $426.58 | Professional | 54 · Surgery only | $281.84 | $281.84 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $87.10 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $57.54 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $57.54 |
Where Ohio sits
The same service costs 7.8 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· 9th of 51
$1,230
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.