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 $229.09 Median $489.78 Typical High $12,589.25 | Facility | None | $229.09 | $489.78 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $154.88 Typical High $426.58 | Professional | None | $83.18 | $154.88 | $426.58 |
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 $77.62 Median $117.49 Typical High $194.98 | Professional | None | $77.62 | $117.49 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $117.49 Typical High $144.54 | Facility | None | $109.65 | $117.49 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $128.82 Typical High $363.08 | Facility | None | $58.88 | $128.82 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $147.91 Typical High $263.03 | Professional | None | $83.18 | $147.91 | $263.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $125.89 Typical High $363.08 | Facility | None | $58.88 | $125.89 | $363.08 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $83.18 Median $147.91 Typical High $263.03 | Professional | None | $83.18 | $147.91 | $263.03 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $263.03 | Professional | None | $144.54 | $190.55 | $263.03 |
SummaCare Setting Facility Modifier None Typical Low $60.26 Median $63.10 Typical High $72.44 | Facility | None | $60.26 | $63.10 | $72.44 |
SummaCare Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $181.97 | Professional | None | $79.43 | $125.89 | $181.97 |
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 $81.28 Median $144.54 Typical High $288.40 | Professional | None | $81.28 | $144.54 | $288.40 |
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 $41.69 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $41.69 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $16.60 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $114.82 Typical High $114.82 | Professional | 54 · Surgery only | $61.66 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $12.30 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $8.32 | $15.49 | $15.49 |
Where Ohio sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 45th of 51
$145
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.