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 $446.68 Median $3,235.94 Typical High $12,589.25 | Facility | None | $446.68 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $3,548.13 | Professional | None | $97.72 | $147.91 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $10,715.19 Typical High $18,620.87 | Facility | None | $3,630.78 | $10,715.19 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $194.98 | Professional | None | $81.28 | $120.23 | $194.98 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $123.03 Median $177.83 Typical High $288.40 | Professional | 50 · Both sides | $123.03 | $177.83 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $691.83 Typical High $2,691.53 | Facility | None | $512.86 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $257.04 | Professional | None | $93.33 | $151.36 | $257.04 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $691.83 Typical High $2,691.53 | Facility | None | $512.86 | $691.83 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $263.03 | Professional | None | $93.33 | $151.36 | $263.03 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $190.55 | Professional | None | $123.03 | $154.88 | $190.55 |
SummaCare Setting Professional Modifier None Typical Low $83.18 Median $141.25 Typical High $213.80 | Professional | None | $83.18 | $141.25 | $213.80 |
United Setting Facility Modifier None Typical Low $97.72 Median $257.04 Typical High $2,398.83 | Facility | None | $97.72 | $257.04 | $2,398.83 |
United Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $316.23 | Professional | None | $97.72 | $165.96 | $316.23 |
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 $48.98 Median $74.13 Typical High $85.11 | Professional | 52 · Reduced service | $48.98 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $29.51 Typical High $33.88 | Professional | 53 · Discontinued | $19.50 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $112.20 Typical High $125.89 | Professional | 54 · Surgery only | $72.44 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $22.39 Typical High $25.70 | Professional | 55 · Aftercare only | $14.45 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $14.79 Typical High $16.98 | Professional | 56 · Pre-op care only | $9.77 | $14.79 | $16.98 |
Where Ohio sits
The same service costs 3.7 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· 48th of 51
$141
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.