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 $125.89 Median $223.87 Typical High $12,589.25 | Facility | None | $125.89 | $223.87 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $69.18 Typical High $602.56 | Professional | None | $44.67 | $69.18 | $602.56 |
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 $45.71 Median $67.61 Typical High $107.15 | Professional | None | $45.71 | $67.61 | $107.15 |
CareSource Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $60.26 | Facility | None | $46.77 | $46.77 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $63.10 Typical High $120.23 | Facility | None | $52.48 | $63.10 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $67.61 Typical High $134.90 | Professional | None | $43.65 | $67.61 | $134.90 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $52.48 Median $63.10 Typical High $120.23 | Facility | None | $52.48 | $63.10 | $120.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $43.65 Median $67.61 Typical High $134.90 | Professional | None | $43.65 | $67.61 | $134.90 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $158.49 | Professional | None | $85.11 | $112.20 | $158.49 |
SummaCare Setting Facility Modifier None Typical Low $28.84 Median $30.20 Typical High $34.67 | Facility | None | $28.84 | $30.20 | $34.67 |
SummaCare Setting Professional Modifier None Typical Low $45.71 Median $70.79 Typical High $102.33 | Professional | None | $45.71 | $70.79 | $102.33 |
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 $41.69 Median $67.61 Typical High $125.89 | Professional | None | $41.69 | $67.61 | $125.89 |
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 $22.39 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $22.39 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $9.12 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $52.48 Typical High $52.48 | Professional | 54 · Surgery only | $33.88 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $6.76 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $4.47 | $7.08 | $7.08 |
Where Ohio sits
The same service costs 3.4 times more in Alaska than in New York. 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· 36th of 51
$75.86
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.