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 $288.40 Median $10,232.93 Typical High $13,803.84 | Facility | None | $288.40 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $288.40 Typical High $398.11 | Professional | None | $165.96 | $288.40 | $398.11 |
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 $114.82 Median $141.25 Typical High $234.42 | Professional | None | $114.82 | $141.25 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $177.83 Typical High $213.80 | Facility | None | $138.04 | $177.83 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $165.96 Typical High $295.12 | Facility | None | $58.88 | $165.96 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $281.84 Typical High $436.52 | Professional | None | $173.78 | $281.84 | $436.52 |
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 $173.78 Median $281.84 Typical High $436.52 | Professional | None | $173.78 | $281.84 | $436.52 |
Molina Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $524.81 | Professional | None | $263.03 | $346.74 | $524.81 |
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 $165.96 Median $269.15 Typical High $389.05 | Professional | None | $165.96 | $269.15 | $389.05 |
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 $117.49 Median $204.17 Typical High $407.38 | Professional | None | $117.49 | $204.17 | $407.38 |
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 $83.18 Median $141.25 Typical High $144.54 | Professional | 52 · Reduced service | $83.18 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $56.23 Typical High $58.88 | Professional | 53 · Discontinued | $33.11 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $208.93 Typical High $218.78 | Professional | 54 · Surgery only | $125.89 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $41.69 Typical High $43.65 | Professional | 55 · Aftercare only | $25.12 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $28.18 Typical High $29.51 | Professional | 56 · Pre-op care only | $16.60 | $28.18 | $29.51 |
Where Ohio sits
The same service costs 4.0 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· 40th of 51
$245
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.