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 $501.19 Median $3,235.94 Typical High $12,589.25 | Facility | None | $501.19 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $123.03 Typical High $239.88 | Professional | None | $44.67 | $123.03 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $10,715.19 Typical High $18,620.87 | Facility | None | $3,630.78 | $10,715.19 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $48.98 Typical High $79.43 | Professional | None | $41.69 | $48.98 | $79.43 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $58.88 Median $72.44 Typical High $112.20 | Professional | 50 · Both sides | $58.88 | $72.44 | $112.20 |
CareSource Setting Facility Modifier None Typical Low $63.10 Median $537.03 Typical High $812.83 | Facility | None | $63.10 | $537.03 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,137.96 Typical High $2,691.53 | Facility | None | $524.81 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $162.18 Typical High $269.15 | Professional | None | $53.70 | $162.18 | $269.15 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $2,137.96 Typical High $2,691.53 | Facility | None | $512.86 | $2,137.96 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $53.70 Median $162.18 Typical High $269.15 | Professional | None | $53.70 | $162.18 | $269.15 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $309.03 | Professional | None | $158.49 | $204.17 | $309.03 |
SummaCare Setting Professional Modifier None Typical Low $45.71 Median $138.04 Typical High $234.42 | Professional | None | $45.71 | $138.04 | $234.42 |
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 $38.02 Median $123.03 Typical High $281.84 | Professional | None | $38.02 | $123.03 | $281.84 |
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 $25.12 Median $97.72 Typical High $102.33 | Professional | 52 · Reduced service | $25.12 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $38.90 Typical High $40.74 | Professional | 53 · Discontinued | $10.00 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $147.91 Typical High $154.88 | Professional | 54 · Surgery only | $37.15 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $29.51 Typical High $30.90 | Professional | 55 · Aftercare only | $7.41 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $19.50 Typical High $20.42 | Professional | 56 · Pre-op care only | $5.01 | $19.50 | $20.42 |
Where Ohio sits
The same service costs 4.6 times more in Iowa than in Kentucky. 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
$138
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.