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 $204.17 Median $2,630.27 Typical High $12,022.64 | Facility | None | $204.17 | $2,630.27 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $2,344.23 | Professional | None | $112.20 | $112.20 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $2,511.89 Typical High $18,620.87 | Facility | None | $549.54 | $2,511.89 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $229.09 | Professional | None | $114.82 | $141.25 | $229.09 |
Aultcare Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $741.31 | Professional | None | $398.11 | $478.63 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $144.54 Median $1,348.96 Typical High $2,041.74 | Facility | None | $144.54 | $1,348.96 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $169.82 | Professional | None | $109.65 | $138.04 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $616.60 Typical High $7,079.46 | Facility | None | $501.19 | $616.60 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $204.17 | Professional | None | $120.23 | $147.91 | $204.17 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $7,079.46 | Facility | None | $501.19 | $1,174.90 | $7,079.46 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $194.98 | Professional | None | $120.23 | $147.91 | $194.98 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | None | $50.12 | $70.79 | $70.79 |
United Setting Facility Modifier None Typical Low $97.72 Median $257.04 Typical High $2,398.83 | Facility | None | $97.72 | $257.04 | $2,398.83 |
United Setting Professional Modifier None Typical Low $74.13 Median $123.03 Typical High $213.80 | Professional | None | $74.13 | $123.03 | $213.80 |
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 $56.23 Median $56.23 Typical High $158.49 | Professional | 52 · Reduced service | $56.23 | $56.23 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $63.10 | Professional | 53 · Discontinued | $22.39 | $22.39 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $234.42 | Professional | 54 · Surgery only | $85.11 | $85.11 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $47.86 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $31.62 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $31.62 |
Where Ohio sits
The same service costs 4.0 times more in Alaska than in Delaware. 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· 39th 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.