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 $1,862.09 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,862.09 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $10,232.93 | Professional | None | $1,862.09 | $1,862.09 | $10,232.93 |
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 $630.96 Median $676.08 Typical High $1,071.52 | Professional | None | $630.96 | $676.08 | $1,071.52 |
CareSource Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
CareSource Setting Professional Modifier None Typical Low $3,162.28 Median $39,810.72 Typical High $70,794.58 | Professional | None | $3,162.28 | $39,810.72 | $70,794.58 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,000.00 Typical High $23,442.29 | Facility | None | $426.58 | $1,000.00 | $23,442.29 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $630.96 Typical High $22,387.21 | Facility | None | $426.58 | $630.96 | $22,387.21 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $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 $81.28 Median $114.82 Typical High $5,754.40 | Professional | None | $81.28 | $114.82 | $5,754.40 |
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 $912.01 Median $933.25 Typical High $1,778.28 | Professional | 52 · Reduced service | $912.01 | $933.25 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $707.95 | Professional | 53 · Discontinued | $371.54 | $371.54 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $281.84 Typical High $524.81 | Professional | 55 · Aftercare only | $275.42 | $281.84 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $186.21 Typical High $354.81 | Professional | 56 · Pre-op care only | $181.97 | $186.21 | $354.81 |
Where Ohio sits
The same service costs 30.9 times more in California than in Idaho. 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· 10th of 51
$1,096
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.