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 $478.63 Median $3,235.94 Typical High $12,589.25 | Facility | None | $478.63 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $138.04 Typical High $537.03 | Professional | None | $66.07 | $138.04 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $16,595.87 Median $16,595.87 Typical High $18,620.87 | Facility | None | $16,595.87 | $16,595.87 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $138.04 Typical High $323.59 | Professional | None | $74.13 | $138.04 | $323.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $109.65 Median $208.93 Typical High $478.63 | Professional | 50 · Both sides | $109.65 | $208.93 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $154.88 Typical High $263.03 | Professional | None | $77.62 | $154.88 | $263.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $77.62 Median $154.88 Typical High $257.04 | Professional | None | $77.62 | $154.88 | $257.04 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $218.78 | Professional | None | $107.15 | $154.88 | $218.78 |
SummaCare Setting Professional Modifier None Typical Low $66.07 Median $158.49 Typical High $204.17 | Professional | None | $66.07 | $158.49 | $204.17 |
United Setting Facility Modifier None Typical Low $478.63 Median $1,445.44 Typical High $3,715.35 | Facility | None | $478.63 | $1,445.44 | $3,715.35 |
United Setting Professional Modifier None Typical Low $66.07 Median $138.04 Typical High $288.40 | Professional | None | $66.07 | $138.04 | $288.40 |
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 $33.11 Median $69.18 Typical High $93.33 | Professional | 52 · Reduced service | $33.11 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $27.54 Typical High $37.15 | Professional | 53 · Discontinued | $13.18 | $27.54 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $104.71 Typical High $138.04 | Professional | 54 · Surgery only | $48.98 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $20.89 Typical High $27.54 | Professional | 55 · Aftercare only | $9.77 | $20.89 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $13.80 Typical High $18.62 | Professional | 56 · Pre-op care only | $6.61 | $13.80 | $18.62 |
Where Ohio sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 38th of 51
$148
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.