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 $95.50 Median $10,232.93 Typical High $13,803.84 | Facility | None | $95.50 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $95.50 Typical High $131.83 | Professional | None | $67.61 | $95.50 | $131.83 |
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 $43.65 Median $54.95 Typical High $93.33 | Professional | None | $43.65 | $54.95 | $93.33 |
CareSource Setting Facility Modifier None Typical Low $64.57 Median $83.18 Typical High $87.10 | Facility | None | $64.57 | $83.18 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $85.11 Typical High $169.82 | Facility | None | $58.88 | $85.11 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $162.18 | Professional | None | $69.18 | $95.50 | $162.18 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $85.11 Typical High $169.82 | Facility | None | $58.88 | $85.11 | $169.82 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $158.49 | Professional | None | $69.18 | $95.50 | $158.49 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $158.49 | Professional | None | $81.28 | $104.71 | $158.49 |
SummaCare Setting Facility Modifier None Typical Low $40.74 Median $42.66 Typical High $48.98 | Facility | None | $40.74 | $42.66 | $48.98 |
SummaCare Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $131.83 | Professional | None | $67.61 | $91.20 | $131.83 |
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 $46.77 Median $77.62 Typical High $144.54 | Professional | None | $46.77 | $77.62 | $144.54 |
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 $33.88 Median $47.86 Typical High $50.12 | Professional | 52 · Reduced service | $33.88 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $19.05 Typical High $19.95 | Professional | 53 · Discontinued | $13.49 | $19.05 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $70.79 Typical High $74.13 | Professional | 54 · Surgery only | $50.12 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $14.13 Typical High $14.79 | Professional | 55 · Aftercare only | $10.00 | $14.13 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $9.55 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.76 | $9.55 | $10.00 |
Where Ohio sits
The same service costs 3.8 times more in Alaska than in Florida. 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
$91.20
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.