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 $61.66 Median $173.78 Typical High $10,232.93 | Facility | None | $61.66 | $173.78 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $295.12 | Professional | None | $43.65 | $54.95 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $70.79 Typical High $97.72 | Professional | None | $58.88 | $70.79 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $10,715.19 Typical High $18,620.87 | Facility | None | $3,630.78 | $10,715.19 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $91.20 | Professional | None | $43.65 | $60.26 | $91.20 |
CareSource Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
CareSource Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $75.86 | Professional | None | $67.61 | $72.44 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $691.83 Typical High $2,691.53 | Facility | None | $512.86 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $123.03 | Professional | None | $50.12 | $61.66 | $123.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $2,691.53 | Facility | None | $501.19 | $707.95 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $123.03 | Professional | None | $50.12 | $61.66 | $123.03 |
Molina Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $109.65 | Professional | None | $61.66 | $81.28 | $109.65 |
SummaCare Setting Professional Modifier None Typical Low $44.67 Median $61.66 Typical High $89.13 | Professional | None | $44.67 | $61.66 | $89.13 |
United Setting Facility Modifier None Typical Low $97.72 Median $257.04 Typical High $2,398.83 | Facility | None | $97.72 | $257.04 | $2,398.83 |
United Setting Professional Modifier None Typical Low $45.71 Median $63.10 Typical High $112.20 | Professional | None | $45.71 | $63.10 | $112.20 |
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 $21.88 Median $26.30 Typical High $28.84 | Professional | 52 · Reduced service | $21.88 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $10.47 Typical High $11.48 | Professional | 53 · Discontinued | $8.71 | $10.47 | $11.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $38.90 Typical High $42.66 | Professional | 54 · Surgery only | $32.36 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $7.76 Typical High $8.51 | Professional | 55 · Aftercare only | $6.46 | $7.76 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.25 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.37 | $5.25 | $5.75 |
Where Ohio sits
The same service costs 4.8 times more in Alaska 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· 35th of 51
$66.07
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.