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 $562.34 Median $4,365.16 Typical High $12,589.25 | Facility | None | $562.34 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $251.19 Typical High $4,786.30 | Professional | None | $123.03 | $251.19 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $933.25 Typical High $3,715.35 | Facility | None | $416.87 | $933.25 | $3,715.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $288.40 | Professional | None | $97.72 | $151.36 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $134.90 Median $616.60 Typical High $794.33 | Facility | None | $134.90 | $616.60 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $707.95 Typical High $1,995.26 | Facility | None | $489.78 | $707.95 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $239.88 Typical High $389.05 | Professional | None | $114.82 | $239.88 | $389.05 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $707.95 Typical High $1,995.26 | Facility | None | $512.86 | $707.95 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $114.82 Median $239.88 Typical High $389.05 | Professional | None | $114.82 | $239.88 | $389.05 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $398.11 | Professional | None | $251.19 | $302.00 | $398.11 |
SummaCare Setting Facility Modifier None Typical Low $338.84 Median $354.81 Typical High $398.11 | Facility | None | $338.84 | $354.81 | $398.11 |
SummaCare Setting Professional Modifier None Typical Low $102.33 Median $257.04 Typical High $331.13 | Professional | None | $102.33 | $257.04 | $331.13 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,388.44 | Facility | None | $363.08 | $691.83 | $3,388.44 |
United Setting Professional Modifier None Typical Low $117.49 Median $213.80 Typical High $457.09 | Professional | None | $117.49 | $213.80 | $457.09 |
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 $60.26 Median $125.89 Typical High $147.91 | Professional | 52 · Reduced service | $60.26 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $50.12 Typical High $58.88 | Professional | 53 · Discontinued | $24.55 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $186.21 Typical High $223.87 | Professional | 54 · Surgery only | $91.20 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $37.15 Typical High $44.67 | Professional | 55 · Aftercare only | $18.20 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $25.12 Typical High $29.51 | Professional | 56 · Pre-op care only | $12.30 | $25.12 | $29.51 |
Where Ohio sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 43rd of 51
$240
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.