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 $5,011.87 Median $10,232.93 Typical High $13,803.84 | Facility | None | $5,011.87 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $11,220.18 | Professional | None | $1,479.11 | $1,479.11 | $11,220.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $19,054.61 Typical High $41,686.94 | Facility | None | $1,479.11 | $19,054.61 | $41,686.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $2,884.03 | Professional | None | $1,548.82 | $1,819.70 | $2,884.03 |
CareSource Setting Professional Modifier None Typical Low $1,949.84 Median $25,118.86 Typical High $43,651.58 | Professional | None | $1,949.84 | $25,118.86 | $43,651.58 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,754.23 Typical High $4,570.88 | Professional | None | $1,905.46 | $2,754.23 | $4,570.88 |
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 $741.31 Median $741.31 Typical High $2,951.21 | Professional | 52 · Reduced service | $741.31 | $741.31 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $1,174.90 | Professional | 53 · Discontinued | $295.12 | $295.12 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $4,365.16 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $870.96 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $588.84 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $588.84 |
Where Ohio sits
The same service costs 5.8 times more in California than in Arkansas. 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· 30th of 51
$2,291
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.