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 $93.33 Median $10,232.93 Typical High $13,803.84 | Facility | None | $93.33 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $93.33 Typical High $389.05 | Professional | None | $58.88 | $93.33 | $389.05 |
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 $52.48 Median $87.10 Typical High $173.78 | Professional | None | $52.48 | $87.10 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $63.10 Median $537.03 Typical High $812.83 | Facility | None | $63.10 | $537.03 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,137.96 Typical High $2,691.53 | Facility | None | $501.19 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $85.11 Typical High $162.18 | Professional | None | $54.95 | $85.11 | $162.18 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $2,290.87 Typical High $2,691.53 | Facility | None | $501.19 | $2,290.87 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $54.95 Median $85.11 Typical High $162.18 | Professional | None | $54.95 | $85.11 | $162.18 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $95.50 | Professional | None | $63.10 | $77.62 | $95.50 |
SummaCare Setting Professional Modifier None Typical Low $46.77 Median $85.11 Typical High $138.04 | Professional | None | $46.77 | $85.11 | $138.04 |
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 $61.66 Median $100.00 Typical High $218.78 | Professional | None | $61.66 | $100.00 | $218.78 |
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 $28.84 Median $46.77 Typical High $54.95 | Professional | 52 · Reduced service | $28.84 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $18.62 Typical High $21.88 | Professional | 53 · Discontinued | $11.75 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $69.18 Typical High $81.28 | Professional | 54 · Surgery only | $43.65 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $14.13 Typical High $16.22 | Professional | 55 · Aftercare only | $8.71 | $14.13 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $9.33 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.89 | $9.33 | $10.96 |
Where Ohio sits
The same service costs 3.7 times more in Wisconsin 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
$89.13
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.