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 $1,122.02 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,122.02 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $4,168.69 | Professional | None | $77.62 | $77.62 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $3,467.37 Typical High $6,760.83 | Facility | None | $724.44 | $3,467.37 | $6,760.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $173.78 | Professional | None | $81.28 | $97.72 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $229.09 | Professional | None | $75.86 | $91.20 | $229.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $239.88 | Professional | None | $75.86 | $91.20 | $239.88 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $112.20 | Professional | None | $70.79 | $87.10 | $112.20 |
SummaCare Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $131.83 | Professional | None | $72.44 | $72.44 | $131.83 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $194.98 | Professional | None | $75.86 | $97.72 | $194.98 |
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 $38.90 Median $38.90 Typical High $245.47 | Professional | 52 · Reduced service | $38.90 | $38.90 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $97.72 | Professional | 53 · Discontinued | $15.49 | $15.49 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $363.08 | Professional | 54 · Surgery only | $57.54 | $57.54 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $72.44 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $48.98 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $48.98 |
Where Ohio sits
The same service costs 6.5 times more in Tennessee 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· 38th of 51
$115
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.