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 $109.65 Median $2,630.27 Typical High $12,022.64 | Facility | None | $109.65 | $2,630.27 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $173.78 Typical High $549.54 | Professional | None | $64.57 | $173.78 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
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 $52.48 Median $64.57 Typical High $123.03 | Professional | None | $52.48 | $64.57 | $123.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $64.57 Median $97.72 Typical High $165.96 | Professional | 50 · Both sides | $64.57 | $97.72 | $165.96 |
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 $69.18 Median $173.78 Typical High $295.12 | Professional | None | $69.18 | $173.78 | $295.12 |
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 $69.18 Median $173.78 Typical High $295.12 | Professional | None | $69.18 | $173.78 | $295.12 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $269.15 | Professional | None | $131.83 | $194.98 | $269.15 |
SummaCare Setting Professional Modifier None Typical Low $57.54 Median $162.18 Typical High $239.88 | Professional | None | $57.54 | $162.18 | $239.88 |
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 $70.79 Median $165.96 Typical High $346.74 | Professional | None | $70.79 | $165.96 | $346.74 |
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 $31.62 Median $89.13 Typical High $114.82 | Professional | 52 · Reduced service | $31.62 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $35.48 Typical High $46.77 | Professional | 53 · Discontinued | $12.88 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $131.83 Typical High $173.78 | Professional | 54 · Surgery only | $47.86 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $26.30 Typical High $34.67 | Professional | 55 · Aftercare only | $9.55 | $26.30 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $17.78 Typical High $22.91 | Professional | 56 · Pre-op care only | $6.46 | $17.78 | $22.91 |
Where Ohio sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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· 35th 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.