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 $1,000.00 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,000.00 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $45.71 Typical High $3,162.28 | Professional | None | $38.90 | $45.71 | $3,162.28 |
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 $38.02 Median $45.71 Typical High $66.07 | Professional | None | $38.02 | $45.71 | $66.07 |
CareSource Setting Facility Modifier None Typical Low $54.95 Median $537.03 Typical High $812.83 | Facility | None | $54.95 | $537.03 | $812.83 |
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 $39.81 Median $43.65 Typical High $89.13 | Professional | None | $39.81 | $43.65 | $89.13 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $851.14 | Facility | None | $50.12 | $66.07 | $851.14 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $89.13 | Professional | None | $39.81 | $43.65 | $89.13 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $41.69 Typical High $56.23 | Professional | None | $30.90 | $41.69 | $56.23 |
SummaCare Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $52.48 | Professional | None | $39.81 | $39.81 | $52.48 |
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 $38.02 Median $48.98 Typical High $100.00 | Professional | None | $38.02 | $48.98 | $100.00 |
6 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 $19.50 Median $19.50 Typical High $102.33 | Professional | 52 · Reduced service | $19.50 | $19.50 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $40.74 | Professional | 53 · Discontinued | $7.76 | $7.76 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $29.51 Typical High $154.88 | Professional | 54 · Surgery only | $29.51 | $29.51 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $30.90 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $20.42 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $20.42 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 58 · Staged procedure | $53.70 | $53.70 | $53.70 |
Where Ohio sits
The same service costs 13.8 times more in Oklahoma 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· 48th of 51
$45.71
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.