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 $389.05 Median $10,232.93 Typical High $13,803.84 | Facility | None | $389.05 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $10,232.93 | Professional | None | $257.04 | $257.04 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $512.86 | Professional | None | $269.15 | $346.74 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
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 $229.09 Median $288.40 Typical High $575.44 | Professional | None | $229.09 | $288.40 | $575.44 |
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 $229.09 Median $288.40 Typical High $575.44 | Professional | None | $229.09 | $288.40 | $575.44 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $295.12 | Professional | None | $190.55 | $234.42 | $295.12 |
SummaCare Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $426.58 | Professional | None | $223.87 | $245.47 | $426.58 |
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 $245.47 Median $363.08 Typical High $691.83 | Professional | None | $245.47 | $363.08 | $691.83 |
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 $128.82 Median $128.82 Typical High $467.74 | Professional | 52 · Reduced service | $128.82 | $128.82 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $186.21 | Professional | 53 · Discontinued | $51.29 | $51.29 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $691.83 | Professional | 54 · Surgery only | $190.55 | $190.55 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $138.04 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $93.33 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $93.33 |
Where Ohio sits
The same service costs 4.0 times more in Wisconsin 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· 40th of 51
$347
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.