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 $1,000.00 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,000.00 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $302.00 Typical High $3,548.13 | Professional | None | $158.49 | $302.00 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $1,148.15 Typical High $4,466.84 | Facility | None | $467.74 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $398.11 | Professional | None | $154.88 | $229.09 | $398.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $338.84 Typical High $602.56 | Professional | 50 · Both sides | $229.09 | $338.84 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $758.58 Typical High $1,000.00 | Facility | None | $194.98 | $758.58 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $891.25 Typical High $1,548.82 | Facility | None | $363.08 | $891.25 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $288.40 Typical High $524.81 | Professional | None | $162.18 | $288.40 | $524.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $891.25 Typical High $1,513.56 | Facility | None | $389.05 | $891.25 | $1,513.56 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $162.18 Median $288.40 Typical High $537.03 | Professional | None | $162.18 | $288.40 | $537.03 |
Molina Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $489.78 | Professional | None | $275.42 | $363.08 | $489.78 |
SummaCare Setting Facility Modifier None Typical Low $436.52 Median $457.09 Typical High $512.86 | Facility | None | $436.52 | $457.09 | $512.86 |
SummaCare Setting Professional Modifier None Typical Low $141.25 Median $309.03 Typical High $398.11 | Professional | None | $141.25 | $309.03 | $398.11 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $537.03 | Professional | None | $151.36 | $263.03 | $537.03 |
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 $79.43 Median $151.36 Typical High $154.88 | Professional | 52 · Reduced service | $79.43 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $60.26 Typical High $61.66 | Professional | 53 · Discontinued | $31.62 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $223.87 Typical High $229.09 | Professional | 54 · Surgery only | $117.49 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $44.67 Typical High $45.71 | Professional | 55 · Aftercare only | $23.44 | $44.67 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $30.20 Typical High $30.90 | Professional | 56 · Pre-op care only | $15.85 | $30.20 | $30.90 |
Where Ohio sits
The same service costs 3.9 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· 46th of 51
$295
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.