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 $89.13 Median $354.81 Typical High $10,715.19 | Facility | None | $89.13 | $354.81 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $87.10 Typical High $380.19 | Professional | None | $47.86 | $87.10 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $114.82 Typical High $114.82 | Professional | None | $64.57 | $114.82 | $114.82 |
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 $56.23 Median $109.65 Typical High $173.78 | Professional | None | $56.23 | $109.65 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $22.39 Median $67.61 Typical High $91.20 | Facility | None | $22.39 | $67.61 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $70.79 Typical High $134.90 | Facility | None | $56.23 | $70.79 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $100.00 Typical High $204.17 | Professional | None | $56.23 | $100.00 | $204.17 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $56.23 Median $70.79 Typical High $194.98 | Facility | None | $56.23 | $70.79 | $194.98 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $56.23 Median $100.00 Typical High $204.17 | Professional | None | $56.23 | $100.00 | $204.17 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $165.96 | Professional | None | $91.20 | $120.23 | $165.96 |
SummaCare Setting Facility Modifier None Typical Low $32.36 Median $34.67 Typical High $38.90 | Facility | None | $32.36 | $34.67 | $38.90 |
SummaCare Setting Professional Modifier None Typical Low $47.86 Median $100.00 Typical High $131.83 | Professional | None | $47.86 | $100.00 | $131.83 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $54.95 Median $100.00 Typical High $190.55 | Professional | None | $54.95 | $100.00 | $190.55 |
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 $23.99 Median $42.66 Typical High $46.77 | Professional | 52 · Reduced service | $23.99 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $17.38 Typical High $18.62 | Professional | 53 · Discontinued | $9.55 | $17.38 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $64.57 Typical High $70.79 | Professional | 54 · Surgery only | $35.48 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $12.88 Typical High $14.13 | Professional | 55 · Aftercare only | $7.08 | $12.88 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $8.71 Typical High $9.33 | Professional | 56 · Pre-op care only | $4.79 | $8.71 | $9.33 |
Where Ohio sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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· 31st of 51
$110
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.