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 $1,479.11 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,479.11 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $4,168.69 | Professional | None | $269.15 | $269.15 | $4,168.69 |
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 $114.82 Median $151.36 Typical High $229.09 | Professional | None | $114.82 | $151.36 | $229.09 |
CareSource Setting Professional Modifier None Typical Low $354.81 Median $4,466.84 Typical High $7,943.28 | Professional | None | $354.81 | $4,466.84 | $7,943.28 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $616.60 Typical High $1,659.59 | Facility | None | $489.78 | $616.60 | $1,659.59 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $489.78 Median $616.60 Typical High $1,659.59 | Facility | None | $489.78 | $616.60 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $60.26 | Professional | None | $50.12 | $50.12 | $60.26 |
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 $263.03 Median $363.08 Typical High $724.44 | Professional | None | $263.03 | $363.08 | $724.44 |
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 $134.90 Median $134.90 Typical High $151.36 | Professional | 52 · Reduced service | $134.90 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $60.26 | Professional | 53 · Discontinued | $53.70 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $223.87 | Professional | 54 · Surgery only | $204.17 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $44.67 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $30.20 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $30.20 |
Where Ohio sits
The same service costs 8.3 times more in Alaska 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· 49th of 51
$186
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.