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 $4,265.80 Median $8,709.64 Typical High $13,803.84 | Facility | None | $4,265.80 | $8,709.64 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $5,128.61 Median $5,888.44 Typical High $13,803.84 | Professional | None | $5,128.61 | $5,888.44 | $13,803.84 |
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 $776.25 Median $10,000.00 Typical High $18,620.87 | Professional | None | $776.25 | $10,000.00 | $18,620.87 |
CareSource Setting Professional Modifier None Typical Low $4,677.35 Median $58,884.37 Typical High $104,712.85 | Professional | None | $4,677.35 | $58,884.37 | $104,712.85 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $8,128.31 Typical High $13,803.84 | Facility | None | $549.54 | $8,128.31 | $13,803.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $8,128.31 Typical High $12,882.50 | Facility | None | $549.54 | $8,128.31 | $12,882.50 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Facility Modifier None Typical Low $4,466.84 Median $4,677.35 Typical High $5,248.07 | Facility | None | $4,466.84 | $4,677.35 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,265.80 Typical High $14,454.40 | Facility | None | $1,071.52 | $4,265.80 | $14,454.40 |
United Setting Professional Modifier None Typical Low $10,232.93 Median $14,125.38 Typical High $29,512.09 | Professional | None | $10,232.93 | $14,125.38 | $29,512.09 |
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 $2,951.21 Median $2,951.21 Typical High $21,877.62 | Professional | 52 · Reduced service | $2,951.21 | $2,951.21 | $21,877.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,174.90 Median $1,174.90 Typical High $8,709.64 | Professional | 53 · Discontinued | $1,174.90 | $1,174.90 | $8,709.64 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,466.84 Median $4,466.84 Typical High $33,113.11 | Professional | 54 · Surgery only | $4,466.84 | $4,466.84 | $33,113.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $891.25 Median $891.25 Typical High $6,606.93 | Professional | 55 · Aftercare only | $891.25 | $891.25 | $6,606.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $588.84 Median $588.84 Typical High $4,365.16 | Professional | 56 · Pre-op care only | $588.84 | $588.84 | $4,365.16 |
Where Ohio sits
The same service costs 16.6 times more in Indiana than in Nebraska. 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
$8,128
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.