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 $16.60 Median $33.88 Typical High $93.33 | Facility | None | $16.60 | $33.88 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $33.11 Typical High $87.10 | Professional | None | $10.00 | $33.11 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $10,715.19 Typical High $18,620.87 | Facility | None | $3,630.78 | $10,715.19 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.32 Median $25.70 Typical High $38.02 | Professional | None | $8.32 | $25.70 | $38.02 |
CareSource Setting Facility Modifier None Typical Low $11.22 Median $537.03 Typical High $812.83 | Facility | None | $11.22 | $537.03 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $33.88 Median $35.48 Typical High $38.02 | Professional | None | $33.88 | $35.48 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,290.87 Typical High $2,691.53 | Facility | None | $524.81 | $2,290.87 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $25.12 Typical High $51.29 | Professional | None | $8.71 | $25.12 | $51.29 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $204.17 Median $707.95 Typical High $2,691.53 | Facility | None | $204.17 | $707.95 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $8.71 Median $25.12 Typical High $52.48 | Professional | None | $8.71 | $25.12 | $52.48 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $38.02 Typical High $40.74 | Professional | None | $33.88 | $38.02 | $40.74 |
SummaCare Setting Professional Modifier None Typical Low $8.32 Median $30.90 Typical High $39.81 | Professional | None | $8.32 | $30.90 | $39.81 |
United Setting Facility Modifier None Typical Low $97.72 Median $257.04 Typical High $2,398.83 | Facility | None | $97.72 | $257.04 | $2,398.83 |
United Setting Professional Modifier None Typical Low $10.00 Median $26.92 Typical High $54.95 | Professional | None | $10.00 | $26.92 | $54.95 |
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 $5.01 Median $16.60 Typical High $19.50 | Professional | 52 · Reduced service | $5.01 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $6.61 Typical High $7.76 | Professional | 53 · Discontinued | $2.00 | $6.61 | $7.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.59 Median $24.55 Typical High $29.51 | Professional | 54 · Surgery only | $7.59 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $4.90 Typical High $5.89 | Professional | 55 · Aftercare only | $1.51 | $4.90 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $3.31 Typical High $3.89 | Professional | 56 · Pre-op care only | $1.00 | $3.31 | $3.89 |
Where Ohio sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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· 47th of 51
$26.30
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.