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 $39.81 Median $151.36 Typical High $10,715.19 | Facility | None | $39.81 | $151.36 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $28.18 Typical High $1,202.26 | Professional | None | $21.88 | $28.18 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $363.08 Median $1,380.38 Typical High $16,595.87 | Facility | None | $363.08 | $1,380.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $28.84 Typical High $46.77 | Professional | None | $20.89 | $28.84 | $46.77 |
CareSource Setting Facility Modifier None Typical Low $30.20 Median $724.44 Typical High $1,096.48 | Facility | None | $30.20 | $724.44 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $616.60 Typical High $2,691.53 | Facility | None | $457.09 | $616.60 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $29.51 Typical High $53.70 | Professional | None | $22.39 | $29.51 | $53.70 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $457.09 Median $630.96 Typical High $2,691.53 | Facility | None | $457.09 | $630.96 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $22.39 Median $29.51 Typical High $53.70 | Professional | None | $22.39 | $29.51 | $53.70 |
Molina Setting Professional Modifier None Typical Low $12.02 Median $14.13 Typical High $18.62 | Professional | None | $12.02 | $14.13 | $18.62 |
SummaCare Setting Professional Modifier None Typical Low $22.91 Median $33.88 Typical High $53.70 | Professional | None | $22.91 | $33.88 | $53.70 |
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 $22.91 Median $33.11 Typical High $56.23 | Professional | None | $22.91 | $33.11 | $56.23 |
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 $10.96 Median $14.13 Typical High $14.79 | Professional | 52 · Reduced service | $10.96 | $14.13 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $5.62 Typical High $5.89 | Professional | 53 · Discontinued | $4.37 | $5.62 | $5.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $20.89 Typical High $22.39 | Professional | 54 · Surgery only | $16.22 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $4.17 Typical High $4.47 | Professional | 55 · Aftercare only | $3.24 | $4.17 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.82 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.19 | $2.82 | $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· 37th of 51
$33.88
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.