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 $10,232.93 Typical High $13,803.84 | Facility | None | $1,000.00 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $10,232.93 | Professional | None | $851.14 | $851.14 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $19,054.61 Typical High $41,686.94 | Facility | None | $1,479.11 | $19,054.61 | $41,686.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,202.26 | Professional | None | $660.69 | $776.25 | $1,202.26 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
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 $741.31 Median $954.99 Typical High $1,737.80 | Professional | None | $741.31 | $954.99 | $1,737.80 |
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 $741.31 Median $954.99 Typical High $1,737.80 | Professional | None | $741.31 | $954.99 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $977.24 | Professional | None | $630.96 | $776.25 | $977.24 |
SummaCare Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,318.26 | Professional | None | $707.95 | $776.25 | $1,318.26 |
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 $812.83 Median $1,122.02 Typical High $2,344.23 | Professional | None | $812.83 | $1,122.02 | $2,344.23 |
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 $426.58 Median $426.58 Typical High $1,412.54 | Professional | 52 · Reduced service | $426.58 | $426.58 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $562.34 | Professional | 53 · Discontinued | $169.82 | $169.82 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $2,089.30 | Professional | 54 · Surgery only | $645.65 | $645.65 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $416.87 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $281.84 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $281.84 |
Where Ohio sits
The same service costs 4.6 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· 42nd of 51
$912
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.