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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $6,918.31 | Professional | None | $489.78 | $489.78 | $6,918.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,096.48 | $3,548.13 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $977.24 | Professional | None | $489.78 | $616.60 | $977.24 |
CareSource Setting Professional Modifier None Typical Low $645.65 Median $8,317.64 Typical High $14,454.40 | Professional | None | $645.65 | $8,317.64 | $14,454.40 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $4,677.35 Typical High $7,943.28 | Facility | None | $549.54 | $4,677.35 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $4,677.35 Typical High $7,413.10 | Facility | None | $549.54 | $4,677.35 | $7,413.10 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
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 $2,570.40 Median $2,691.53 Typical High $3,019.95 | Facility | None | $2,570.40 | $2,691.53 | $3,019.95 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | None | $50.12 | $70.79 | $70.79 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $316.23 Median $537.03 Typical High $933.25 | Professional | None | $316.23 | $537.03 | $933.25 |
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 $239.88 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $239.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $95.50 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $363.08 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $72.44 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $47.86 | $48.98 | $48.98 |
Where Ohio sits
The same service costs 7.2 times more in Texas than in Pennsylvania. 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· 38th of 51
$617
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.