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 $2,454.71 Median $6,918.31 Typical High $12,022.64 | Facility | None | $2,454.71 | $6,918.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $7,762.47 | Professional | None | $1,380.38 | $1,380.38 | $7,762.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,698.24 Typical High $7,585.78 | Facility | None | $645.65 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $316.23 | Professional | None | $173.78 | $213.80 | $316.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $263.03 Median $323.59 Typical High $489.78 | Professional | 50 · Both sides | $263.03 | $323.59 | $489.78 |
CareSource Setting Facility Modifier None Typical Low $257.04 Median $1,905.46 Typical High $2,454.71 | Facility | None | $257.04 | $1,905.46 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,041.74 Typical High $3,090.30 | Facility | None | $562.34 | $2,041.74 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $891.25 | Professional | None | $181.97 | $204.17 | $891.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $2,951.21 | Facility | None | $602.56 | $2,041.74 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $204.17 | Professional | None | $181.97 | $181.97 | $204.17 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $549.54 Typical High $549.54 | Professional | None | $60.26 | $549.54 | $549.54 |
SummaCare Setting Facility Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,202.26 | Facility | None | $1,000.00 | $1,047.13 | $1,202.26 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
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 $691.83 Median $691.83 Typical High $2,454.71 | Professional | 52 · Reduced service | $691.83 | $691.83 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $977.24 | Professional | 53 · Discontinued | $275.42 | $275.42 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $3,630.78 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $724.44 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $489.78 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $489.78 |
Where Ohio sits
The same service costs 67.6 times more in Oklahoma than in Montana. 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· 46th of 51
$269
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.