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 $1,949.84 Median $4,570.88 Typical High $12,589.25 | Facility | None | $1,949.84 | $4,570.88 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $9,772.37 | Professional | None | $64.57 | $64.57 | $9,772.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,096.48 | $3,548.13 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,659.59 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,454.71 Typical High $3,801.89 | Professional | 50 · Both sides | $1,995.26 | $2,454.71 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $630.96 Typical High $2,691.53 | Facility | None | $501.19 | $630.96 | $2,691.53 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $691.83 Typical High $2,691.53 | Facility | None | $501.19 | $691.83 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Facility Modifier None Typical Low $4,897.79 Median $5,128.61 Typical High $5,888.44 | Facility | None | $4,897.79 | $5,128.61 | $5,888.44 |
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 $891.25 Median $3,162.28 Typical High $10,471.29 | Facility | None | $891.25 | $3,162.28 | $10,471.29 |
United Setting Professional Modifier None Typical Low $630.96 Median $1,096.48 Typical High $1,819.70 | Professional | None | $630.96 | $1,096.48 | $1,819.70 |
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 $32.36 Median $32.36 Typical High $512.86 | Professional | 52 · Reduced service | $32.36 | $32.36 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $208.93 | Professional | 53 · Discontinued | $12.88 | $12.88 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $48.98 Typical High $776.25 | Professional | 54 · Surgery only | $48.98 | $48.98 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $154.88 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $977.24 Typical High $977.24 | Professional | 56 · Pre-op care only | $100.00 | $977.24 | $977.24 |
Where Ohio sits
The same service costs 50.1 times more in Oklahoma than in North Carolina. 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
$1,622
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.