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 $954.99 Median $3,235.94 Typical High $12,589.25 | Facility | None | $954.99 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $562.34 Typical High $1,513.56 | Professional | None | $165.96 | $562.34 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $16,595.87 Median $16,595.87 Typical High $18,620.87 | Facility | None | $16,595.87 | $16,595.87 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $302.00 Typical High $794.33 | Professional | None | $154.88 | $302.00 | $794.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $234.42 Median $446.68 Typical High $1,202.26 | Professional | 50 · Both sides | $234.42 | $446.68 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $416.87 Typical High $812.83 | Professional | None | $151.36 | $416.87 | $812.83 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $151.36 Median $436.52 Typical High $776.25 | Professional | None | $151.36 | $436.52 | $776.25 |
Molina Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $870.96 | Professional | None | $467.74 | $630.96 | $870.96 |
SummaCare Setting Professional Modifier None Typical Low $141.25 Median $501.19 Typical High $660.69 | Professional | None | $141.25 | $501.19 | $660.69 |
United Setting Facility Modifier None Typical Low $478.63 Median $1,445.44 Typical High $3,715.35 | Facility | None | $478.63 | $1,445.44 | $3,715.35 |
United Setting Professional Modifier None Typical Low $158.49 Median $467.74 Typical High $891.25 | Professional | None | $158.49 | $467.74 | $891.25 |
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 $83.18 Median $281.84 Typical High $371.54 | Professional | 52 · Reduced service | $83.18 | $281.84 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $112.20 Typical High $147.91 | Professional | 53 · Discontinued | $33.11 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $416.87 Typical High $549.54 | Professional | 54 · Surgery only | $125.89 | $416.87 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $83.18 Typical High $109.65 | Professional | 55 · Aftercare only | $25.12 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $56.23 Typical High $74.13 | Professional | 56 · Pre-op care only | $16.60 | $56.23 | $74.13 |
Where Ohio sits
The same service costs 3.5 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· 32nd of 51
$479
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.