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 $602.56 Median $602.56 Typical High $10,232.93 | Professional | None | $602.56 | $602.56 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $69.18 Typical High $446.68 | Professional | None | $57.54 | $69.18 | $446.68 |
CareSource Setting Professional Modifier None Typical Low $1,047.13 Median $13,182.57 Typical High $23,442.29 | Professional | None | $1,047.13 | $13,182.57 | $23,442.29 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $4,897.79 Typical High $8,317.64 | Facility | None | $549.54 | $4,897.79 | $8,317.64 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $4,897.79 Typical High $7,762.47 | Facility | None | $549.54 | $4,897.79 | $7,762.47 |
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 $2,691.53 Median $2,818.38 Typical High $3,162.28 | Facility | None | $2,691.53 | $2,818.38 | $3,162.28 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $1,905.46 | Professional | None | $354.81 | $512.86 | $1,905.46 |
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 $302.00 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $60.26 |
Where Ohio sits
The same service costs 14.8 times more in Texas 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· 44th of 51
$603
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.