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 $707.95 Median $3,801.89 Typical High $12,022.64 | Facility | None | $707.95 | $3,801.89 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $2,089.30 Typical High $5,754.40 | Professional | None | $380.19 | $2,089.30 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $3,388.44 Typical High $20,417.38 | Facility | None | $1,862.09 | $3,388.44 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $1,621.81 Typical High $3,019.95 | Professional | None | $363.08 | $1,621.81 | $3,019.95 |
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 $346.74 Median $1,047.13 Typical High $3,235.94 | Professional | None | $346.74 | $1,047.13 | $3,235.94 |
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 $346.74 Median $1,071.52 Typical High $3,019.95 | Professional | None | $346.74 | $1,071.52 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $1,621.81 Median $2,187.76 Typical High $3,090.30 | Professional | None | $1,621.81 | $2,187.76 | $3,090.30 |
SummaCare Setting Professional Modifier None Typical Low $316.23 Median $1,862.09 Typical High $2,398.83 | Professional | None | $316.23 | $1,862.09 | $2,398.83 |
United Setting Facility Modifier None Typical Low $5,248.07 Median $9,549.93 Typical High $15,488.17 | Facility | None | $5,248.07 | $9,549.93 | $15,488.17 |
United Setting Professional Modifier None Typical Low $380.19 Median $1,949.84 Typical High $3,801.89 | Professional | None | $380.19 | $1,949.84 | $3,801.89 |
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 $190.55 Median $1,023.29 Typical High $1,148.15 | Professional | 52 · Reduced service | $190.55 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $416.87 Typical High $457.09 | Professional | 53 · Discontinued | $77.62 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $1,548.82 Typical High $1,737.80 | Professional | 54 · Surgery only | $288.40 | $1,548.82 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $309.03 Typical High $346.74 | Professional | 55 · Aftercare only | $57.54 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $208.93 Typical High $229.09 | Professional | 56 · Pre-op care only | $38.02 | $208.93 | $229.09 |
Where Ohio sits
The same service costs 6.9 times more in Wisconsin than in Hawaii. 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· 27th of 51
$1,950
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.