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 $223.87 Median $1,995.26 Typical High $10,964.78 | Facility | None | $223.87 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $537.03 | Professional | None | $81.28 | $125.89 | $537.03 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
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 $85.11 Median $125.89 Typical High $190.55 | Professional | None | $85.11 | $125.89 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $91.20 Typical High $114.82 | Facility | None | $70.79 | $91.20 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $134.90 Typical High $1,479.11 | Facility | None | $75.86 | $134.90 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $251.19 | Professional | None | $81.28 | $123.03 | $251.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $75.86 Median $134.90 Typical High $1,479.11 | Facility | None | $75.86 | $134.90 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $251.19 | Professional | None | $81.28 | $123.03 | $251.19 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $213.80 | Professional | None | $114.82 | $151.36 | $213.80 |
SummaCare Setting Facility Modifier None Typical Low $81.28 Median $85.11 Typical High $97.72 | Facility | None | $81.28 | $85.11 | $97.72 |
SummaCare Setting Professional Modifier None Typical Low $83.18 Median $147.91 Typical High $218.78 | Professional | None | $83.18 | $147.91 | $218.78 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,311.31 | Facility | None | $363.08 | $691.83 | $3,311.31 |
United Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $229.09 | Professional | None | $79.43 | $131.83 | $229.09 |
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 $40.74 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $40.74 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $16.22 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $93.33 Typical High $93.33 | Professional | 54 · Surgery only | $61.66 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $12.30 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $8.13 | $12.59 | $12.59 |
Where Ohio sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 37th of 51
$138
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.