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 $338.84 Median $338.84 Typical High $10,232.93 | Professional | None | $338.84 | $338.84 | $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 $338.84 Median $398.11 Typical High $602.56 | Professional | None | $338.84 | $398.11 | $602.56 |
CareSource Setting Professional Modifier None Typical Low $446.68 Median $5,623.41 Typical High $10,000.00 | Professional | None | $446.68 | $5,623.41 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $7,413.10 Typical High $12,589.25 | Facility | None | $549.54 | $7,413.10 | $12,589.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $7,413.10 Typical High $11,748.98 | Facility | None | $549.54 | $7,413.10 | $11,748.98 |
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 $4,073.80 Median $4,265.80 Typical High $4,786.30 | Facility | None | $4,073.80 | $4,265.80 | $4,786.30 |
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 $407.38 Median $575.44 Typical High $1,071.52 | Professional | None | $407.38 | $575.44 | $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 $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
Where Ohio sits
The same service costs 32.4 times more in Oklahoma than in New York. 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.