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 $416.87 Median $416.87 Typical High $10,232.93 | Professional | None | $416.87 | $416.87 | $10,232.93 |
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 $426.58 Median $501.19 Typical High $812.83 | Professional | None | $426.58 | $501.19 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $549.54 Median $6,918.31 Typical High $12,302.69 | Professional | None | $549.54 | $6,918.31 | $12,302.69 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $7,244.36 Typical High $12,302.69 | Facility | None | $549.54 | $7,244.36 | $12,302.69 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $7,244.36 Typical High $11,481.54 | Facility | None | $549.54 | $7,244.36 | $11,481.54 |
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 $3,890.45 Median $4,073.80 Typical High $4,677.35 | Facility | None | $3,890.45 | $4,073.80 | $4,677.35 |
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 $331.13 Median $457.09 Typical High $1,412.54 | Professional | None | $331.13 | $457.09 | $1,412.54 |
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 $199.53 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $199.53 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $79.43 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $302.00 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $60.26 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $39.81 | $41.69 | $41.69 |
Where Ohio sits
The same service costs 16.2 times more in Arkansas than in West Virginia. 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· 32nd of 51
$692
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.