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 $1,621.81 Median $7,244.36 Typical High $12,589.25 | Facility | None | $1,621.81 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $9,549.93 | Professional | None | $151.36 | $151.36 | $9,549.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $2,238.72 Typical High $7,079.46 | Facility | None | $691.83 | $2,238.72 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $275.42 | Professional | None | $125.89 | $147.91 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $4,265.80 Typical High $5,495.41 | Facility | None | $169.82 | $4,265.80 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,019.95 Typical High $5,128.61 | Facility | None | $602.56 | $3,019.95 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $363.08 | Professional | None | $141.25 | $169.82 | $363.08 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $3,019.95 Typical High $4,786.30 | Facility | None | $602.56 | $3,019.95 | $4,786.30 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $331.13 | Professional | None | $144.54 | $169.82 | $331.13 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $204.17 | Professional | None | $123.03 | $154.88 | $204.17 |
SummaCare Setting Facility Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $1,949.84 | Facility | None | $1,659.59 | $1,737.80 | $1,949.84 |
SummaCare Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $245.47 | Professional | None | $128.82 | $141.25 | $245.47 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $11,748.98 | Facility | None | $912.01 | $3,388.44 | $11,748.98 |
United Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $407.38 | Professional | None | $144.54 | $194.98 | $407.38 |
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 $75.86 Median $75.86 Typical High $213.80 | Professional | 52 · Reduced service | $75.86 | $75.86 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $87.10 | Professional | 53 · Discontinued | $30.90 | $30.90 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $323.59 | Professional | 54 · Surgery only | $114.82 | $114.82 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $64.57 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $42.66 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $42.66 |
Where Ohio sits
The same service costs 20.4 times more in Kansas 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· 48th of 51
$195
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.