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 $91.20 Median $478.63 Typical High $10,715.19 | Facility | None | $91.20 | $478.63 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $131.83 Typical High $478.63 | Professional | None | $48.98 | $131.83 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
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 $51.29 Median $112.20 Typical High $190.55 | Professional | None | $51.29 | $112.20 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $69.18 Median $107.15 Typical High $141.25 | Facility | None | $69.18 | $107.15 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $190.55 Typical High $1,479.11 | Facility | None | $109.65 | $190.55 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $120.23 Typical High $245.47 | Professional | None | $48.98 | $120.23 | $245.47 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $109.65 Median $190.55 Typical High $1,479.11 | Facility | None | $109.65 | $190.55 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $48.98 Median $125.89 Typical High $218.78 | Professional | None | $48.98 | $125.89 | $218.78 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $213.80 | Professional | None | $112.20 | $151.36 | $213.80 |
SummaCare Setting Facility Modifier None Typical Low $58.88 Median $61.66 Typical High $70.79 | Facility | None | $58.88 | $61.66 | $70.79 |
SummaCare Setting Professional Modifier None Typical Low $47.86 Median $120.23 Typical High $173.78 | Professional | None | $47.86 | $120.23 | $173.78 |
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 $53.70 Median $120.23 Typical High $245.47 | Professional | None | $53.70 | $120.23 | $245.47 |
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 $24.55 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $24.55 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $9.77 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $97.72 Typical High $97.72 | Professional | 54 · Surgery only | $37.15 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $7.41 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $4.90 | $13.18 | $13.18 |
Where Ohio sits
The same service costs 2.6 times more in Alaska than in Montana. 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· 42nd of 51
$132
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.