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 $1,905.46 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,905.46 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,905.46 Typical High $10,232.93 | Professional | None | $1,862.09 | $1,905.46 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $7,762.47 | Facility | None | $851.14 | $2,630.27 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $3,715.35 | Professional | None | $1,949.84 | $2,290.87 | $3,715.35 |
CareSource Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,388.44 | $3,388.44 | $3,388.44 |
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 $331.13 Median $416.87 Typical High $478.63 | Professional | None | $331.13 | $416.87 | $478.63 |
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 $331.13 Median $416.87 Typical High $478.63 | Professional | None | $331.13 | $416.87 | $478.63 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
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 |
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 $933.25 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $933.25 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $371.54 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,412.54 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $281.84 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $186.21 | $190.55 | $190.55 |
Where Ohio sits
The same service costs 162.2 times more in Wisconsin than in Hawaii. 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· 11th of 51
$2,291
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.