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 $269.15 Median $10,232.93 Typical High $13,803.84 | Facility | None | $269.15 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $537.03 | Professional | None | $154.88 | $269.15 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $239.88 | Professional | None | $117.49 | $144.54 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $177.83 Typical High $199.53 | Facility | None | $138.04 | $177.83 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $162.18 Typical High $281.84 | Facility | None | $58.88 | $162.18 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $426.58 | Professional | None | $158.49 | $263.03 | $426.58 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $162.18 Typical High $275.42 | Facility | None | $58.88 | $162.18 | $275.42 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $416.87 | Professional | None | $158.49 | $263.03 | $416.87 |
Molina Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $467.74 | Professional | None | $239.88 | $309.03 | $467.74 |
SummaCare Setting Facility Modifier None Typical Low $79.43 Median $83.18 Typical High $93.33 | Facility | None | $79.43 | $83.18 | $93.33 |
SummaCare Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $363.08 | Professional | None | $154.88 | $251.19 | $363.08 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $380.19 | Professional | None | $114.82 | $194.98 | $380.19 |
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 $77.62 Median $131.83 Typical High $134.90 | Professional | 52 · Reduced service | $77.62 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $52.48 Typical High $53.70 | Professional | 53 · Discontinued | $30.90 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $194.98 Typical High $199.53 | Professional | 54 · Surgery only | $114.82 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $38.90 Typical High $40.74 | Professional | 55 · Aftercare only | $23.44 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $26.30 Typical High $26.92 | Professional | 56 · Pre-op care only | $15.49 | $26.30 | $26.92 |
Where Ohio sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 41st of 51
$240
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.