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 $141.25 Median $630.96 Typical High $10,715.19 | Facility | None | $141.25 | $630.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $181.97 Typical High $524.81 | Professional | None | $77.62 | $181.97 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $93.33 Typical High $158.49 | Professional | None | $57.54 | $93.33 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $16,595.87 Median $16,595.87 Typical High $18,620.87 | Facility | None | $16,595.87 | $16,595.87 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $208.93 Typical High $295.12 | Professional | None | $87.10 | $208.93 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $158.49 Typical High $275.42 | Professional | None | $74.13 | $158.49 | $275.42 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $74.13 Median $158.49 Typical High $257.04 | Professional | None | $74.13 | $158.49 | $257.04 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $218.78 | Professional | None | $107.15 | $158.49 | $218.78 |
SummaCare Setting Professional Modifier None Typical Low $64.57 Median $165.96 Typical High $208.93 | Professional | None | $64.57 | $165.96 | $208.93 |
United Setting Facility Modifier None Typical Low $478.63 Median $1,445.44 Typical High $3,715.35 | Facility | None | $478.63 | $1,445.44 | $3,715.35 |
United Setting Professional Modifier None Typical Low $75.86 Median $169.82 Typical High $316.23 | Professional | None | $75.86 | $169.82 | $316.23 |
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 $38.90 Median $91.20 Typical High $102.33 | Professional | 52 · Reduced service | $38.90 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $36.31 Typical High $40.74 | Professional | 53 · Discontinued | $15.49 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $138.04 Typical High $154.88 | Professional | 54 · Surgery only | $57.54 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $27.54 Typical High $30.20 | Professional | 55 · Aftercare only | $11.48 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $18.20 Typical High $20.42 | Professional | 56 · Pre-op care only | $7.76 | $18.20 | $20.42 |
Where Ohio sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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· 26th of 51
$182
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.