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 $416.87 Median $1,995.26 Typical High $10,964.78 | Facility | None | $416.87 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $794.33 | Professional | None | $151.36 | $239.88 | $794.33 |
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 $144.54 Typical High $234.42 | Professional | None | $114.82 | $144.54 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $177.83 Typical High $194.98 | Facility | None | $138.04 | $177.83 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $165.96 Typical High $281.84 | Facility | None | $58.88 | $165.96 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $371.54 | Professional | None | $158.49 | $234.42 | $371.54 |
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 $234.42 Typical High $371.54 | Professional | None | $158.49 | $234.42 | $371.54 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $416.87 | Professional | None | $213.80 | $275.42 | $416.87 |
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 $151.36 Median $229.09 Typical High $331.13 | Professional | None | $151.36 | $229.09 | $331.13 |
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 $190.55 Typical High $354.81 | Professional | None | $114.82 | $190.55 | $354.81 |
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 $75.86 Median $120.23 Typical High $125.89 | Professional | 52 · Reduced service | $75.86 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $47.86 Typical High $50.12 | Professional | 53 · Discontinued | $30.20 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $181.97 Typical High $186.21 | Professional | 54 · Surgery only | $114.82 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $36.31 Typical High $37.15 | Professional | 55 · Aftercare only | $22.91 | $36.31 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $23.99 Typical High $25.12 | Professional | 56 · Pre-op care only | $15.14 | $23.99 | $25.12 |
Where Ohio sits
The same service costs 3.9 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
$229
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.