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 $933.25 Median $3,715.35 Typical High $12,022.64 | Facility | None | $933.25 | $3,715.35 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $3,715.35 | Professional | None | $338.84 | $338.84 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $144.54 | Professional | None | $72.44 | $91.20 | $144.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $109.65 Median $138.04 Typical High $213.80 | Professional | 50 · Both sides | $109.65 | $138.04 | $213.80 |
CareSource Setting Professional Modifier None Typical Low $537.03 Median $6,918.31 Typical High $12,302.69 | Professional | None | $537.03 | $6,918.31 | $12,302.69 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,511.89 Typical High $6,025.60 | Facility | None | $549.54 | $2,511.89 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $2,511.89 Typical High $6,025.60 | Facility | None | $549.54 | $2,511.89 | $6,025.60 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $60.26 Typical High $60.26 | Professional | None | $39.81 | $60.26 | $60.26 |
SummaCare Setting Facility Modifier None Typical Low $1,230.27 Median $1,288.25 Typical High $1,445.44 | Facility | None | $1,230.27 | $1,288.25 | $1,445.44 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | None | $50.12 | $70.79 | $70.79 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $229.09 Median $398.11 Typical High $660.69 | Professional | None | $229.09 | $398.11 | $660.69 |
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 $169.82 Median $169.82 Typical High $223.87 | Professional | 52 · Reduced service | $169.82 | $169.82 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $89.13 | Professional | 53 · Discontinued | $67.61 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $331.13 | Professional | 54 · Surgery only | $257.04 | $257.04 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $66.07 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $44.67 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $44.67 |
Where Ohio sits
The same service costs 28.2 times more in Texas 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· 47th of 51
$229
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.