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 $125.89 Median $295.12 Typical High $12,022.64 | Facility | None | $125.89 | $295.12 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $117.49 Typical High $323.59 | Professional | None | $67.61 | $117.49 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $134.90 | Professional | None | $102.33 | $102.33 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $87.10 Typical High $158.49 | Professional | None | $58.88 | $87.10 | $158.49 |
Aultcare Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $141.25 | Professional | None | $134.90 | $134.90 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $72.44 Median $85.11 Typical High $93.33 | Facility | None | $72.44 | $85.11 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $83.18 Typical High $162.18 | Facility | None | $58.88 | $83.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $123.03 Typical High $213.80 | Professional | None | $67.61 | $123.03 | $213.80 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $83.18 Typical High $165.96 | Facility | None | $58.88 | $83.18 | $165.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $190.55 | Professional | None | $72.44 | $112.20 | $190.55 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $158.49 | Professional | None | $85.11 | $112.20 | $158.49 |
SummaCare Setting Facility Modifier None Typical Low $39.81 Median $41.69 Typical High $46.77 | Facility | None | $39.81 | $41.69 | $46.77 |
SummaCare Setting Professional Modifier None Typical Low $57.54 Median $95.50 Typical High $141.25 | Professional | None | $57.54 | $95.50 | $141.25 |
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 $66.07 Median $109.65 Typical High $194.98 | Professional | None | $66.07 | $109.65 | $194.98 |
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 $33.88 Median $58.88 Typical High $60.26 | Professional | 52 · Reduced service | $33.88 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $23.44 Typical High $23.99 | Professional | 53 · Discontinued | $13.49 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $89.13 Typical High $89.13 | Professional | 54 · Surgery only | $51.29 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $10.23 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $11.75 Typical High $12.02 | Professional | 56 · Pre-op care only | $6.76 | $11.75 | $12.02 |
Where Ohio sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 44th of 51
$112
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.