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 $125.89 Median $489.78 Typical High $10,715.19 | Facility | None | $125.89 | $489.78 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $125.89 Typical High $2,089.30 | Professional | None | $60.26 | $125.89 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $457.09 Median $1,148.15 Typical High $4,466.84 | Facility | None | $457.09 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $109.65 Typical High $199.53 | Professional | None | $61.66 | $109.65 | $199.53 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $87.10 Median $165.96 Typical High $302.00 | Professional | 50 · Both sides | $87.10 | $165.96 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $85.11 Median $691.83 Typical High $891.25 | Facility | None | $85.11 | $691.83 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $1,479.11 | Facility | None | $363.08 | $794.33 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $147.91 Typical High $245.47 | Professional | None | $72.44 | $147.91 | $245.47 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $794.33 Typical High $1,479.11 | Facility | None | $389.05 | $794.33 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $72.44 Median $147.91 Typical High $245.47 | Professional | None | $72.44 | $147.91 | $245.47 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $218.78 | Professional | None | $120.23 | $162.18 | $218.78 |
SummaCare Setting Facility Modifier None Typical Low $380.19 Median $398.11 Typical High $457.09 | Facility | None | $380.19 | $398.11 | $457.09 |
SummaCare Setting Professional Modifier None Typical Low $64.57 Median $162.18 Typical High $199.53 | Professional | None | $64.57 | $162.18 | $199.53 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $60.26 Median $123.03 Typical High $263.03 | Professional | None | $60.26 | $123.03 | $263.03 |
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 $30.20 Median $63.10 Typical High $67.61 | Professional | 52 · Reduced service | $30.20 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $25.12 Typical High $26.92 | Professional | 53 · Discontinued | $12.02 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $95.50 Typical High $100.00 | Professional | 54 · Surgery only | $45.71 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $19.05 Typical High $19.95 | Professional | 55 · Aftercare only | $9.12 | $19.05 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $12.59 Typical High $13.49 | Professional | 56 · Pre-op care only | $6.03 | $12.59 | $13.49 |
Where Ohio sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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· 40th of 51
$141
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.