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 $3,162.28 Median $9,772.37 Typical High $12,882.50 | Facility | None | $3,162.28 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $10,232.93 | Professional | None | $1,445.44 | $1,445.44 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $7,762.47 | Facility | None | $851.14 | $2,630.27 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $3,090.30 Typical High $5,888.44 | Professional | None | $812.83 | $3,090.30 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $1,905.46 Median $23,988.33 Typical High $42,657.95 | Professional | None | $1,905.46 | $23,988.33 | $42,657.95 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $7,079.46 Typical High $12,022.64 | Facility | None | $549.54 | $7,079.46 | $12,022.64 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $7,079.46 Typical High $11,481.54 | Facility | None | $549.54 | $7,079.46 | $11,481.54 |
SummaCare Setting Facility Modifier None Typical Low $3,890.45 Median $4,073.80 Typical High $4,677.35 | Facility | None | $3,890.45 | $4,073.80 | $4,677.35 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $2,137.96 Typical High $3,630.78 | Professional | None | $1,479.11 | $2,137.96 | $3,630.78 |
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 $724.44 Median $724.44 Typical High $851.14 | Professional | 52 · Reduced service | $724.44 | $724.44 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $338.84 | Professional | 53 · Discontinued | $288.40 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $257.04 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $169.82 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $169.82 |
Where Ohio sits
The same service costs 4.9 times more in Alaska than in Indiana. 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· 22nd of 51
$2,630
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.