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 $138.04 Median $138.04 Typical High $446.68 | Professional | None | $138.04 | $138.04 | $446.68 |
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 $107.15 Median $125.89 Typical High $190.55 | Professional | None | $107.15 | $125.89 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $154.88 Median $229.09 Typical High $295.12 | Facility | None | $154.88 | $229.09 | $295.12 |
CareSource Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $147.91 | Professional | None | $131.83 | $131.83 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $363.08 Typical High $1,479.11 | Facility | None | $234.42 | $363.08 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $239.88 | Professional | None | $123.03 | $134.90 | $239.88 |
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 $123.03 Median $134.90 Typical High $239.88 | Professional | None | $123.03 | $134.90 | $239.88 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $158.49 | Professional | None | $83.18 | $107.15 | $158.49 |
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 $117.49 Median $117.49 Typical High $138.04 | Professional | None | $117.49 | $117.49 | $138.04 |
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 $107.15 Median $151.36 Typical High $213.80 | Professional | None | $107.15 | $151.36 | $213.80 |
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 $69.18 Median $69.18 Typical High $93.33 | Professional | 52 · Reduced service | $69.18 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $37.15 | Professional | 53 · Discontinued | $27.54 | $27.54 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | 54 · Surgery only | $104.71 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $28.18 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $18.62 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $18.62 |
Where Ohio sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 44th of 51
$132
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.