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 $2,344.23 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,344.23 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $10,232.93 | Professional | None | $323.59 | $323.59 | $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 $87.10 Median $107.15 Typical High $331.13 | Professional | None | $87.10 | $107.15 | $331.13 |
CareSource Setting Professional Modifier None Typical Low $426.58 Median $5,495.41 Typical High $9,549.93 | Professional | None | $426.58 | $5,495.41 | $9,549.93 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,238.72 Typical High $3,467.37 | Facility | None | $549.54 | $2,238.72 | $3,467.37 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $2,238.72 Typical High $3,388.44 | Facility | None | $549.54 | $2,238.72 | $3,388.44 |
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 $2,137.96 Median $2,238.72 Typical High $2,570.40 | Facility | None | $2,137.96 | $2,238.72 | $2,570.40 |
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 $478.63 Median $812.83 Typical High $1,071.52 | Professional | None | $478.63 | $812.83 | $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 $162.18 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $32.36 |
Where Ohio sits
The same service costs 10.2 times more in Texas 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· 45th of 51
$617
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.