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 $24.55 Median $107.15 Typical High $10,715.19 | Facility | None | $24.55 | $107.15 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $29.51 Typical High $97.72 | Professional | None | $12.88 | $29.51 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $11.75 Median $33.11 Typical High $47.86 | Professional | None | $11.75 | $33.11 | $47.86 |
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 $13.49 Median $20.89 Typical High $38.02 | Professional | None | $13.49 | $20.89 | $38.02 |
CareSource Setting Facility Modifier None Typical Low $17.78 Median $537.03 Typical High $812.83 | Facility | None | $17.78 | $537.03 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $40.74 | Professional | None | $33.11 | $33.11 | $40.74 |
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 $12.59 Median $26.30 Typical High $50.12 | Professional | None | $12.59 | $26.30 | $50.12 |
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 $12.59 Median $26.30 Typical High $50.12 | Professional | None | $12.59 | $26.30 | $50.12 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $37.15 Typical High $53.70 | Professional | None | $27.54 | $37.15 | $53.70 |
SummaCare Setting Professional Modifier None Typical Low $13.18 Median $26.92 Typical High $38.02 | Professional | None | $13.18 | $26.92 | $38.02 |
United Setting Facility Modifier None Typical Low $97.72 Median $251.19 Typical High $2,398.83 | Facility | None | $97.72 | $251.19 | $2,398.83 |
United Setting Professional Modifier None Typical Low $13.18 Median $25.12 Typical High $50.12 | Professional | None | $13.18 | $25.12 | $50.12 |
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 $6.46 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $6.46 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $2.57 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.77 Median $21.88 Typical High $21.88 | Professional | 54 · Surgery only | $9.77 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $1.95 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $1.29 | $2.95 | $2.95 |
Where Ohio sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 43rd of 51
$28.18
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.