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 $1,122.02 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,122.02 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $194.98 | Professional | None | $54.95 | $54.95 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $51.29 Typical High $83.18 | Professional | None | $43.65 | $51.29 | $83.18 |
CareSource Setting Facility Modifier None Typical Low $60.26 Median $229.09 Typical High $295.12 | Facility | None | $60.26 | $229.09 | $295.12 |
CareSource Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $57.54 | Professional | None | $51.29 | $51.29 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $354.81 Typical High $1,479.11 | Facility | None | $234.42 | $354.81 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $100.00 | Professional | None | $47.86 | $53.70 | $100.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $234.42 Median $354.81 Typical High $1,479.11 | Facility | None | $234.42 | $354.81 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $100.00 | Professional | None | $47.86 | $53.70 | $100.00 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $38.02 Typical High $56.23 | Professional | None | $28.84 | $38.02 | $56.23 |
SummaCare Setting Facility Modifier None Typical Low $251.19 Median $263.03 Typical High $302.00 | Facility | None | $251.19 | $263.03 | $302.00 |
SummaCare Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $51.29 | Professional | None | $43.65 | $43.65 | $51.29 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $42.66 Median $61.66 Typical High $85.11 | Professional | None | $42.66 | $61.66 | $85.11 |
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 $27.54 Median $27.54 Typical High $35.48 | Professional | 52 · Reduced service | $27.54 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $14.13 | Professional | 53 · Discontinued | $10.96 | $10.96 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $41.69 Typical High $52.48 | Professional | 54 · Surgery only | $41.69 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $10.47 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $7.08 |
Where Ohio sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 46th of 51
$53.70
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.