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 $74.13 Median $204.17 Typical High $12,589.25 | Facility | None | $74.13 | $204.17 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $74.13 Typical High $123.03 | Professional | None | $46.77 | $74.13 | $123.03 |
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 $36.31 Median $42.66 Typical High $72.44 | Professional | None | $36.31 | $42.66 | $72.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $51.29 Median $63.10 Typical High $104.71 | Professional | 50 · Both sides | $51.29 | $63.10 | $104.71 |
CareSource Setting Facility Modifier None Typical Low $54.95 Median $60.26 Typical High $70.79 | Facility | None | $54.95 | $60.26 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $67.61 Typical High $131.83 | Facility | None | $54.95 | $67.61 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $123.03 | Professional | None | $51.29 | $75.86 | $123.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $54.95 Median $67.61 Typical High $128.82 | Facility | None | $54.95 | $67.61 | $128.82 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $120.23 | Professional | None | $51.29 | $75.86 | $120.23 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $158.49 | Professional | None | $79.43 | $104.71 | $158.49 |
SummaCare Setting Facility Modifier None Typical Low $31.62 Median $33.11 Typical High $37.15 | Facility | None | $31.62 | $33.11 | $37.15 |
SummaCare Setting Professional Modifier None Typical Low $45.71 Median $66.07 Typical High $95.50 | Professional | None | $45.71 | $66.07 | $95.50 |
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 $34.67 Median $57.54 Typical High $109.65 | Professional | None | $34.67 | $57.54 | $109.65 |
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 $23.44 Median $37.15 Typical High $38.02 | Professional | 52 · Reduced service | $23.44 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $14.79 Typical High $15.49 | Professional | 53 · Discontinued | $9.55 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $54.95 Typical High $57.54 | Professional | 54 · Surgery only | $35.48 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.96 Typical High $11.48 | Professional | 55 · Aftercare only | $7.08 | $10.96 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $7.41 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.68 | $7.41 | $7.59 |
Where Ohio sits
The same service costs 3.6 times more in Alaska 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· 38th of 51
$74.13
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.