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 $912.01 Median $7,079.46 Typical High $12,589.25 | Facility | None | $912.01 | $7,079.46 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $229.09 Typical High $5,754.40 | Professional | None | $123.03 | $229.09 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $316.23 | Professional | None | $109.65 | $138.04 | $316.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $165.96 Median $208.93 Typical High $467.74 | Professional | 50 · Both sides | $165.96 | $208.93 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $1,479.11 Typical High $1,949.84 | Facility | None | $173.78 | $1,479.11 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,698.24 Typical High $2,691.53 | Facility | None | $537.03 | $1,698.24 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $275.42 Typical High $478.63 | Professional | None | $144.54 | $275.42 | $478.63 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $1,698.24 Typical High $2,691.53 | Facility | None | $549.54 | $1,698.24 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $144.54 Median $275.42 Typical High $489.78 | Professional | None | $144.54 | $275.42 | $489.78 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $436.52 | Professional | None | $245.47 | $323.59 | $436.52 |
SummaCare Setting Facility Modifier None Typical Low $831.76 Median $870.96 Typical High $977.24 | Facility | None | $831.76 | $870.96 | $977.24 |
SummaCare Setting Professional Modifier None Typical Low $128.82 Median $288.40 Typical High $363.08 | Professional | None | $128.82 | $288.40 | $363.08 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $120.23 Median $229.09 Typical High $478.63 | Professional | None | $120.23 | $229.09 | $478.63 |
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 $61.66 Median $114.82 Typical High $125.89 | Professional | 52 · Reduced service | $61.66 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $45.71 Typical High $51.29 | Professional | 53 · Discontinued | $24.55 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $173.78 Typical High $190.55 | Professional | 54 · Surgery only | $93.33 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $34.67 Typical High $38.02 | Professional | 55 · Aftercare only | $18.62 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $22.91 Typical High $25.12 | Professional | 56 · Pre-op care only | $12.30 | $22.91 | $25.12 |
Where Ohio sits
The same service costs 5.8 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· 48th of 51
$229
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.