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 $295.12 Median $812.83 Typical High $10,715.19 | Facility | None | $295.12 | $812.83 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $1,230.27 | Professional | None | $165.96 | $245.47 | $1,230.27 |
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 $165.96 Median $269.15 Typical High $407.38 | Professional | None | $165.96 | $269.15 | $407.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $398.11 Typical High $616.60 | Professional | 50 · Both sides | $257.04 | $398.11 | $616.60 |
CareSource Setting Facility Modifier None Typical Low $204.17 Median $758.58 Typical High $1,000.00 | Facility | None | $204.17 | $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 $169.82 Median $251.19 Typical High $512.86 | Professional | None | $169.82 | $251.19 | $512.86 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $891.25 Typical High $1,548.82 | Facility | None | $389.05 | $891.25 | $1,548.82 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $524.81 | Professional | None | $169.82 | $251.19 | $524.81 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $436.52 | Professional | None | $245.47 | $323.59 | $436.52 |
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 $147.91 Median $257.04 Typical High $338.84 | Professional | None | $147.91 | $257.04 | $338.84 |
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 $173.78 Median $263.03 Typical High $501.19 | Professional | None | $173.78 | $263.03 | $501.19 |
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 $120.23 Typical High $128.82 | Professional | 52 · Reduced service | $83.18 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $48.98 Typical High $51.29 | Professional | 53 · Discontinued | $33.11 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $181.97 Typical High $190.55 | Professional | 54 · Surgery only | $123.03 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $36.31 Typical High $38.02 | Professional | 55 · Aftercare only | $24.55 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $24.55 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.60 | $24.55 | $25.70 |
Where Ohio sits
The same service costs 3.1 times more in Alaska than in New York. 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· 37th of 51
$309
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.