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 $602.56 Median $4,365.16 Typical High $12,589.25 | Facility | None | $602.56 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $3,548.13 | Professional | None | $128.82 | $208.93 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $7,585.78 | Facility | None | $588.84 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $288.40 | Professional | None | $123.03 | $173.78 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $158.49 Median $1,548.82 Typical High $2,041.74 | Facility | None | $158.49 | $1,548.82 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,778.28 Typical High $2,570.40 | Facility | None | $489.78 | $1,778.28 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $389.05 | Professional | None | $128.82 | $204.17 | $389.05 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,778.28 Typical High $2,511.89 | Facility | None | $512.86 | $1,778.28 | $2,511.89 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $389.05 | Professional | None | $128.82 | $204.17 | $389.05 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $331.13 | Professional | None | $181.97 | $245.47 | $331.13 |
SummaCare Setting Facility Modifier None Typical Low $870.96 Median $912.01 Typical High $1,047.13 | Facility | None | $870.96 | $912.01 | $1,047.13 |
SummaCare Setting Professional Modifier None Typical Low $114.82 Median $213.80 Typical High $281.84 | Professional | None | $114.82 | $213.80 | $281.84 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $380.19 | Professional | None | $117.49 | $190.55 | $380.19 |
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 $63.10 Median $104.71 Typical High $107.15 | Professional | 52 · Reduced service | $63.10 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $41.69 Typical High $42.66 | Professional | 53 · Discontinued | $25.70 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $158.49 Typical High $158.49 | Professional | 54 · Surgery only | $95.50 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $31.62 Typical High $32.36 | Professional | 55 · Aftercare only | $19.05 | $31.62 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $20.89 Typical High $21.38 | Professional | 56 · Pre-op care only | $12.88 | $20.89 | $21.38 |
Where Ohio sits
The same service costs 3.7 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
$209
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.