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 $2,754.23 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,754.23 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $10,232.93 | Professional | None | $501.19 | $501.19 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $4,677.35 Typical High $21,877.62 | Facility | None | $1,479.11 | $4,677.35 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $912.01 | Professional | None | $489.78 | $575.44 | $912.01 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $8,317.64 Typical High $14,791.08 | Professional | None | $660.69 | $8,317.64 | $14,791.08 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $17,782.79 Typical High $28,840.32 | Facility | None | $549.54 | $17,782.79 | $28,840.32 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $17,782.79 Typical High $28,183.83 | Facility | None | $549.54 | $17,782.79 | $28,183.83 |
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 $9,772.37 Median $10,232.93 Typical High $11,748.98 | Facility | None | $9,772.37 | $10,232.93 | $11,748.98 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $10,000.00 Typical High $45,708.82 | Facility | None | $1,288.25 | $10,000.00 | $45,708.82 |
United Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $1,548.82 | Professional | None | $524.81 | $707.95 | $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 $245.47 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $245.47 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $97.72 | $100.00 | $100.00 |
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 $48.98 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $48.98 | $50.12 | $50.12 |
Where Ohio sits
The same service costs 29.5 times more in Louisiana than in Maine. 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
$832
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.