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 $229.09 Median $1,995.26 Typical High $10,964.78 | Facility | None | $229.09 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $281.84 Typical High $870.96 | Professional | None | $79.43 | $281.84 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
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 $66.07 Median $77.62 Typical High $151.36 | Professional | None | $66.07 | $77.62 | $151.36 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $93.33 Median $114.82 Typical High $213.80 | Professional | 50 · Both sides | $93.33 | $114.82 | $213.80 |
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 $85.11 Median $229.09 Typical High $457.09 | Professional | None | $85.11 | $229.09 | $457.09 |
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 $85.11 Median $229.09 Typical High $457.09 | Professional | None | $85.11 | $229.09 | $457.09 |
Molina Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $489.78 | Professional | None | $257.04 | $354.81 | $489.78 |
SummaCare Setting Professional Modifier None Typical Low $72.44 Median $309.03 Typical High $416.87 | Professional | None | $72.44 | $309.03 | $416.87 |
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 $87.10 Median $257.04 Typical High $501.19 | Professional | None | $87.10 | $257.04 | $501.19 |
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 $39.81 Median $141.25 Typical High $186.21 | Professional | 52 · Reduced service | $39.81 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $56.23 Typical High $74.13 | Professional | 53 · Discontinued | $15.85 | $56.23 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $213.80 Typical High $281.84 | Professional | 54 · Surgery only | $58.88 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $42.66 Typical High $56.23 | Professional | 55 · Aftercare only | $11.75 | $42.66 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $28.18 Typical High $37.15 | Professional | 56 · Pre-op care only | $7.94 | $28.18 | $37.15 |
Where Ohio sits
The same service costs 4.2 times more in Washington than in Virginia. 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· 32nd of 51
$224
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.