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 $467.74 Median $3,235.94 Typical High $12,589.25 | Facility | None | $467.74 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $199.53 Typical High $2,630.27 | Professional | None | $63.10 | $199.53 | $2,630.27 |
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 $72.44 Median $194.98 Typical High $354.81 | Professional | None | $72.44 | $194.98 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
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 $83.18 Median $239.88 Typical High $467.74 | Professional | None | $83.18 | $239.88 | $467.74 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $83.18 Median $239.88 Typical High $489.78 | Professional | None | $83.18 | $239.88 | $489.78 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $380.19 | Professional | None | $213.80 | $281.84 | $380.19 |
SummaCare Setting Professional Modifier None Typical Low $69.18 Median $213.80 Typical High $302.00 | Professional | None | $69.18 | $213.80 | $302.00 |
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 $75.86 Median $218.78 Typical High $467.74 | Professional | None | $75.86 | $218.78 | $467.74 |
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 $31.62 Median $97.72 Typical High $117.49 | Professional | 52 · Reduced service | $31.62 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $39.81 Typical High $45.71 | Professional | 53 · Discontinued | $12.59 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $147.91 Typical High $177.83 | Professional | 54 · Surgery only | $47.86 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $29.51 Typical High $34.67 | Professional | 55 · Aftercare only | $9.55 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $19.95 Typical High $22.91 | Professional | 56 · Pre-op care only | $6.31 | $19.95 | $22.91 |
Where Ohio sits
The same service costs 4.5 times more in Oklahoma than in Nebraska. 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· 27th of 51
$240
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.