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 $69.18 Median $1,995.26 Typical High $10,964.78 | Facility | None | $69.18 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $51.29 Typical High $2,344.23 | Professional | None | $25.12 | $51.29 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $2,511.89 Typical High $18,620.87 | Facility | None | $549.54 | $2,511.89 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $52.48 Typical High $83.18 | Professional | None | $26.92 | $52.48 | $83.18 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $537.03 Typical High $812.83 | Facility | None | $416.87 | $537.03 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $977.24 Typical High $2,691.53 | Facility | None | $50.12 | $977.24 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $48.98 Typical High $97.72 | Professional | None | $25.12 | $48.98 | $97.72 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $977.24 Typical High $2,691.53 | Facility | None | $50.12 | $977.24 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $25.12 Median $48.98 Typical High $100.00 | Professional | None | $25.12 | $48.98 | $100.00 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $37.15 Typical High $53.70 | Professional | None | $28.18 | $37.15 | $53.70 |
SummaCare Setting Professional Modifier None Typical Low $25.12 Median $52.48 Typical High $75.86 | Professional | None | $25.12 | $52.48 | $75.86 |
United Setting Facility Modifier None Typical Low $97.72 Median $257.04 Typical High $2,398.83 | Facility | None | $97.72 | $257.04 | $2,398.83 |
United Setting Professional Modifier None Typical Low $24.55 Median $48.98 Typical High $93.33 | Professional | None | $24.55 | $48.98 | $93.33 |
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 $12.59 Median $25.70 Typical High $26.30 | Professional | 52 · Reduced service | $12.59 | $25.70 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $5.01 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $38.90 Typical High $39.81 | Professional | 54 · Surgery only | $18.62 | $38.90 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $7.76 Typical High $7.94 | Professional | 55 · Aftercare only | $3.80 | $7.76 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $2.51 | $5.25 | $5.25 |
Where Ohio sits
The same service costs 4.0 times more in Alaska than in Texas. 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
$51.29
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.