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 $354.81 Median $354.81 Typical High $10,232.93 | Professional | None | $354.81 | $354.81 | $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 $398.11 Median $467.74 Typical High $741.31 | Professional | None | $398.11 | $467.74 | $741.31 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $5,888.44 Typical High $10,471.29 | Professional | None | $457.09 | $5,888.44 | $10,471.29 |
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 $338.84 Median $467.74 Typical High $1,071.52 | Professional | None | $338.84 | $467.74 | $1,071.52 |
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 $169.82 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $169.82 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $67.61 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $251.19 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $50.12 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $33.88 | $35.48 | $35.48 |
Where Ohio sits
The same service costs 15.8 times more in Arkansas 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· 33rd of 51
$646
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.