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 $758.58 Median $3,235.94 Typical High $10,964.78 | Facility | None | $758.58 | $3,235.94 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $1,348.96 Typical High $3,467.37 | Professional | None | $275.42 | $1,348.96 | $3,467.37 |
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 $223.87 Median $870.96 Typical High $1,778.28 | Professional | None | $223.87 | $870.96 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $1,318.26 Typical High $2,691.53 | Professional | 50 · Both sides | $338.84 | $1,318.26 | $2,691.53 |
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 $234.42 Median $758.58 Typical High $2,137.96 | Professional | None | $234.42 | $758.58 | $2,137.96 |
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 $234.42 Median $758.58 Typical High $2,137.96 | Professional | None | $234.42 | $758.58 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,318.26 | $1,778.28 | $2,511.89 |
SummaCare Setting Professional Modifier None Typical Low $234.42 Median $1,479.11 Typical High $1,949.84 | Professional | None | $234.42 | $1,479.11 | $1,949.84 |
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 $251.19 Median $1,148.15 Typical High $2,187.76 | Professional | None | $251.19 | $1,148.15 | $2,187.76 |
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 $138.04 Median $676.08 Typical High $870.96 | Professional | 52 · Reduced service | $138.04 | $676.08 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $269.15 Typical High $346.74 | Professional | 53 · Discontinued | $54.95 | $269.15 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $1,023.29 Typical High $1,288.25 | Professional | 54 · Surgery only | $208.93 | $1,023.29 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $204.17 Typical High $257.04 | Professional | 55 · Aftercare only | $41.69 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $134.90 Typical High $173.78 | Professional | 56 · Pre-op care only | $27.54 | $134.90 | $173.78 |
Where Ohio sits
The same service costs 6.5 times more in Washington 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· 26th of 51
$1,202
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.