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 $309.03 Median $8,317.64 Typical High $12,882.50 | Facility | None | $309.03 | $8,317.64 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $2,344.23 Typical High $9,772.37 | Professional | None | $165.96 | $2,344.23 | $9,772.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $7,079.46 | Facility | None | $758.58 | $2,187.76 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $269.15 | Professional | None | $141.25 | $165.96 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $208.93 Median $4,073.80 Typical High $5,248.07 | Facility | None | $208.93 | $4,073.80 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $4,466.84 Typical High $6,760.83 | Facility | None | $549.54 | $4,466.84 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $478.63 Typical High $3,801.89 | Professional | None | $165.96 | $478.63 | $3,801.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $4,466.84 Typical High $6,760.83 | Facility | None | $549.54 | $4,466.84 | $6,760.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $165.96 Median $478.63 Typical High $3,801.89 | Professional | None | $165.96 | $478.63 | $3,801.89 |
Molina Setting Professional Modifier None Typical Low $2,187.76 Median $2,884.03 Typical High $3,981.07 | Professional | None | $2,187.76 | $2,884.03 | $3,981.07 |
SummaCare Setting Facility Modifier None Typical Low $2,137.96 Median $2,238.72 Typical High $2,570.40 | Facility | None | $2,137.96 | $2,238.72 | $2,570.40 |
SummaCare Setting Professional Modifier None Typical Low $147.91 Median $426.58 Typical High $3,019.95 | Professional | None | $147.91 | $426.58 | $3,019.95 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $173.78 Median $2,398.83 Typical High $5,248.07 | Professional | None | $173.78 | $2,398.83 | $5,248.07 |
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 $1,174.90 Typical High $2,630.27 | Professional | 52 · Reduced service | $83.18 | $1,174.90 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $467.74 Typical High $1,047.13 | Professional | 53 · Discontinued | $33.11 | $467.74 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $1,737.80 Typical High $3,890.45 | Professional | 54 · Surgery only | $125.89 | $1,737.80 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $346.74 Typical High $776.25 | Professional | 55 · Aftercare only | $25.12 | $346.74 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $234.42 Typical High $524.81 | Professional | 56 · Pre-op care only | $16.60 | $234.42 | $524.81 |
Where Ohio sits
The same service costs 33.1 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· 35th of 51
$2,138
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.