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 $1,380.38 Median $3,467.37 Typical High $12,589.25 | Facility | None | $1,380.38 | $3,467.37 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $4,786.30 | Professional | None | $630.96 | $630.96 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $138.04 Typical High $338.84 | Professional | None | $74.13 | $138.04 | $338.84 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $5,888.44 Typical High $10,232.93 | Professional | None | $457.09 | $5,888.44 | $10,232.93 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $467.74 Typical High $1,995.26 | Facility | None | $295.12 | $467.74 | $1,995.26 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $295.12 Median $467.74 Typical High $1,995.26 | Facility | None | $295.12 | $467.74 | $1,995.26 |
SummaCare Setting Facility Modifier None Typical Low $158.49 Median $165.96 Typical High $190.55 | Facility | None | $158.49 | $165.96 | $190.55 |
SummaCare Setting Professional Modifier None Typical Low $114.82 Median $275.42 Typical High $2,511.89 | Professional | None | $114.82 | $275.42 | $2,511.89 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,311.31 | Facility | None | $363.08 | $691.83 | $3,311.31 |
United Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $407.38 | Professional | None | $144.54 | $181.97 | $407.38 |
4 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 $138.04 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $138.04 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $54.95 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $40.74 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $27.54 | $63.10 | $63.10 |
Where Ohio sits
The same service costs 24.5 times more in Texas than in Missouri. 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
$166
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.