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 $1,380.38 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,380.38 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $9,332.54 | Professional | None | $1,380.38 | $1,380.38 | $9,332.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,715.35 Typical High $19,054.61 | Facility | None | $1,047.13 | $3,715.35 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,348.96 | $2,137.96 |
CareSource Setting Professional Modifier None Typical Low $1,819.70 Median $23,442.29 Typical High $40,738.03 | Professional | None | $1,819.70 | $23,442.29 | $40,738.03 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $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 $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,995.26 Typical High $4,365.16 | Professional | None | $1,445.44 | $1,995.26 | $4,365.16 |
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 $691.83 Median $691.83 Typical High $3,801.89 | Professional | 52 · Reduced service | $691.83 | $691.83 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $1,513.56 | Professional | 53 · Discontinued | $275.42 | $275.42 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $5,623.41 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $5,623.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $1,122.02 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $758.58 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $758.58 |
Where Ohio sits
The same service costs 6.8 times more in Alaska than in Arkansas. 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· 41st of 51
$1,413
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.