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 $83.18 Median $10,232.93 Typical High $13,803.84 | Facility | None | $83.18 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $776.25 | Professional | None | $69.18 | $69.18 | $776.25 |
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 $53.70 Typical High $79.43 | Professional | None | $45.71 | $53.70 | $79.43 |
CareSource Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $416.87 | Facility | None | $316.23 | $316.23 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $426.58 Typical High $724.44 | Facility | None | $58.88 | $426.58 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $131.83 | Professional | None | $63.10 | $81.28 | $131.83 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $426.58 Typical High $691.83 | Facility | None | $58.88 | $426.58 | $691.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $131.83 | Professional | None | $63.10 | $81.28 | $131.83 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Facility Modifier None Typical Low $208.93 Median $218.78 Typical High $251.19 | Facility | None | $208.93 | $218.78 | $251.19 |
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 $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 $60.26 Median $77.62 Typical High $147.91 | Professional | None | $60.26 | $77.62 | $147.91 |
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 $33.88 Median $33.88 Typical High $144.54 | Professional | 52 · Reduced service | $33.88 | $33.88 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $57.54 | Professional | 53 · Discontinued | $13.80 | $13.80 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $51.29 Typical High $213.80 | Professional | 54 · Surgery only | $51.29 | $51.29 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $43.65 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $28.84 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $28.84 |
Where Ohio sits
The same service costs 5.5 times more in Arkansas than in Kentucky. 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· 49th of 51
$66.07
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.