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 $1,479.11 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,479.11 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $933.25 | Professional | None | $114.82 | $114.82 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $851.14 Typical High $3,388.44 | Facility | None | $389.05 | $851.14 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $151.36 | Professional | None | $77.62 | $91.20 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $229.09 Typical High $295.12 | Facility | None | $131.83 | $229.09 | $295.12 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $125.89 | Professional | None | $112.20 | $112.20 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $398.11 Typical High $2,398.83 | Facility | None | $234.42 | $398.11 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $177.83 | Professional | None | $95.50 | $114.82 | $177.83 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $234.42 Median $389.05 Typical High $2,398.83 | Facility | None | $234.42 | $389.05 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $173.78 | Professional | None | $100.00 | $114.82 | $173.78 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $162.18 | Professional | None | $83.18 | $104.71 | $162.18 |
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 $91.20 Median $91.20 Typical High $107.15 | Professional | None | $91.20 | $91.20 | $107.15 |
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 $89.13 Median $114.82 Typical High $177.83 | Professional | None | $89.13 | $114.82 | $177.83 |
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 $57.54 Median $57.54 Typical High $75.86 | Professional | 52 · Reduced service | $57.54 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $30.20 | Professional | 53 · Discontinued | $22.91 | $22.91 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $114.82 | Professional | 54 · Surgery only | $87.10 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $22.91 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $15.14 |
Where Ohio sits
The same service costs 4.8 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· 38th of 51
$115
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.