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 $213.80 Median $2,951.21 Typical High $12,022.64 | Facility | None | $213.80 | $2,951.21 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $9,332.54 | Professional | None | $128.82 | $128.82 | $9,332.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,659.59 Typical High $7,585.78 | Facility | None | $562.34 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $204.17 | Professional | None | $100.00 | $117.49 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $1,548.82 Typical High $1,995.26 | Facility | None | $141.25 | $1,548.82 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,949.84 Typical High $3,090.30 | Facility | None | $363.08 | $1,949.84 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $281.84 | Professional | None | $114.82 | $138.04 | $281.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $1,949.84 Typical High $3,090.30 | Facility | None | $389.05 | $1,949.84 | $3,090.30 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $281.84 | Professional | None | $114.82 | $138.04 | $281.84 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $144.54 | Professional | None | $95.50 | $117.49 | $144.54 |
SummaCare Setting Facility Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,258.93 | Facility | None | $1,071.52 | $1,122.02 | $1,258.93 |
SummaCare Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $199.53 | Professional | None | $102.33 | $112.20 | $199.53 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $346.74 | Professional | None | $120.23 | $154.88 | $346.74 |
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 $64.57 Median $64.57 Typical High $213.80 | Professional | 52 · Reduced service | $64.57 | $64.57 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $85.11 | Professional | 53 · Discontinued | $25.70 | $25.70 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $316.23 | Professional | 54 · Surgery only | $97.72 | $97.72 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $64.57 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $42.66 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $42.66 |
Where Ohio sits
The same service costs 12.9 times more in Arkansas than in New York. 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· 49th of 51
$151
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.