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 $81.28 Median $190.55 Typical High $12,022.64 | Facility | None | $81.28 | $190.55 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $102.33 Typical High $281.84 | Professional | None | $44.67 | $102.33 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $107.15 Typical High $229.09 | Professional | None | $46.77 | $107.15 | $229.09 |
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 $40.74 Median $66.07 Typical High $117.49 | Professional | None | $40.74 | $66.07 | $117.49 |
Aultcare Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $134.90 | Professional | None | $128.82 | $128.82 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $63.10 Median $537.03 Typical High $812.83 | Facility | None | $63.10 | $537.03 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $147.91 | Professional | None | $120.23 | $120.23 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $794.33 | Facility | None | $50.12 | $66.07 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $97.72 Typical High $165.96 | Professional | None | $43.65 | $97.72 | $165.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $630.96 | Facility | None | $50.12 | $66.07 | $630.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $45.71 Median $93.33 Typical High $154.88 | Professional | None | $45.71 | $93.33 | $154.88 |
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 Professional Modifier None Typical Low $42.66 Median $70.79 Typical High $147.91 | Professional | None | $42.66 | $70.79 | $147.91 |
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 $43.65 Median $81.28 Typical High $186.21 | Professional | None | $43.65 | $81.28 | $186.21 |
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 $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $21.88 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $8.91 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $77.62 Typical High $77.62 | Professional | 54 · Surgery only | $33.11 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $6.61 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $4.47 | $10.23 | $10.23 |
Where Ohio sits
The same service costs 3.5 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· 40th of 51
$93.33
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.