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 $602.56 Median $3,235.94 Typical High $10,964.78 | Facility | None | $602.56 | $3,235.94 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $1,023.29 Typical High $2,818.38 | Professional | None | $218.78 | $1,023.29 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,659.59 | $3,311.31 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $831.76 Typical High $1,548.82 | Professional | None | $218.78 | $831.76 | $1,548.82 |
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 $199.53 Median $602.56 Typical High $1,584.89 | Professional | None | $199.53 | $602.56 | $1,584.89 |
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 $199.53 Median $602.56 Typical High $1,513.56 | Professional | None | $199.53 | $602.56 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,584.89 | Professional | None | $831.76 | $1,122.02 | $1,584.89 |
SummaCare Setting Professional Modifier None Typical Low $186.21 Median $933.25 Typical High $1,202.26 | Professional | None | $186.21 | $933.25 | $1,202.26 |
United Setting Facility Modifier None Typical Low $3,548.13 Median $6,606.93 Typical High $9,772.37 | Facility | None | $3,548.13 | $6,606.93 | $9,772.37 |
United Setting Professional Modifier None Typical Low $213.80 Median $954.99 Typical High $1,905.46 | Professional | None | $213.80 | $954.99 | $1,905.46 |
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 $109.65 Median $512.86 Typical High $645.65 | Professional | 52 · Reduced service | $109.65 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $204.17 Typical High $257.04 | Professional | 53 · Discontinued | $43.65 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $776.25 Typical High $954.99 | Professional | 54 · Surgery only | $165.96 | $776.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $154.88 Typical High $194.98 | Professional | 55 · Aftercare only | $33.11 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $102.33 Typical High $128.82 | Professional | 56 · Pre-op care only | $21.88 | $102.33 | $128.82 |
Where Ohio sits
The same service costs 5.9 times more in Wisconsin than in Maryland. 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· 25th of 51
$977
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.