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 $1,174.90 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,174.90 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $4,168.69 | Professional | None | $302.00 | $302.00 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $323.59 Typical High $602.56 | Professional | None | $109.65 | $323.59 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $537.03 Typical High $1,479.11 | Facility | None | $371.54 | $537.03 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $616.60 | Professional | None | $380.19 | $467.74 | $616.60 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $371.54 Median $537.03 Typical High $1,479.11 | Facility | None | $371.54 | $537.03 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $630.96 | Professional | None | $380.19 | $467.74 | $630.96 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $50.12 Typical High $60.26 | Professional | None | $30.20 | $50.12 | $60.26 |
SummaCare Setting Facility Modifier None Typical Low $199.53 Median $208.93 Typical High $239.88 | Facility | None | $199.53 | $208.93 | $239.88 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,311.31 | Facility | None | $363.08 | $691.83 | $3,311.31 |
United Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $794.33 | Professional | None | $302.00 | $446.68 | $794.33 |
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 $151.36 Median $151.36 Typical High $537.03 | Professional | 52 · Reduced service | $151.36 | $151.36 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $218.78 | Professional | 53 · Discontinued | $60.26 | $60.26 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $812.83 | Professional | 54 · Surgery only | $223.87 | $223.87 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $162.18 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $109.65 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $109.65 |
Where Ohio sits
The same service costs 4.1 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· 37th of 51
$447
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.