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 $109.65 Median $10,232.93 Typical High $13,803.84 | Facility | None | $109.65 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $12,589.25 | Professional | None | $109.65 | $109.65 | $12,589.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $9,332.54 | Facility | None | $1,000.00 | $2,187.76 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $144.54 Typical High $234.42 | Professional | None | $89.13 | $144.54 | $234.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $134.90 Median $218.78 Typical High $346.74 | Professional | 50 · Both sides | $134.90 | $218.78 | $346.74 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $1,819.70 Typical High $3,235.94 | Professional | None | $144.54 | $1,819.70 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $4,677.35 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,677.35 | $7,762.47 |
United Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $363.08 | Professional | None | $114.82 | $144.54 | $363.08 |
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 $54.95 Median $54.95 Typical High $758.58 | Professional | 52 · Reduced service | $54.95 | $54.95 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $302.00 | Professional | 53 · Discontinued | $21.88 | $21.88 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $1,122.02 | Professional | 54 · Surgery only | $81.28 | $81.28 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $223.87 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $151.36 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $151.36 |
Where Ohio sits
The same service costs 51.3 times more in Oklahoma than in Kentucky. 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· 34th of 51
$162
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.