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 $2,951.21 Median $10,232.93 Typical High $19,498.45 | Facility | None | $2,951.21 | $10,232.93 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $13,803.84 | Professional | None | $354.81 | $354.81 | $13,803.84 |
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 $316.23 Median $371.54 Typical High $588.84 | Professional | None | $316.23 | $371.54 | $588.84 |
CareSource Setting Professional Modifier None Typical Low $467.74 Median $5,888.44 Typical High $10,471.29 | Professional | None | $467.74 | $5,888.44 | $10,471.29 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $19,952.62 Typical High $31,622.78 | Facility | None | $549.54 | $19,952.62 | $31,622.78 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $19,952.62 Typical High $30,902.95 | Facility | None | $549.54 | $19,952.62 | $30,902.95 |
SummaCare Setting Facility Modifier None Typical Low $19,952.62 Median $19,952.62 Typical High $19,952.62 | Facility | None | $19,952.62 | $19,952.62 | $19,952.62 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $10,000.00 Typical High $45,708.82 | Facility | None | $1,288.25 | $10,000.00 | $45,708.82 |
United Setting Professional Modifier None Typical Low $562.34 Median $1,096.48 Typical High $1,513.56 | Professional | None | $562.34 | $1,096.48 | $1,513.56 |
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 $177.83 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $35.48 |
Where Ohio sits
The same service costs 50.1 times more in Arkansas 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· 43rd of 51
$955
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.