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 $676.08 Median $3,019.95 Typical High $12,022.64 | Facility | None | $676.08 | $3,019.95 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $691.83 | Professional | None | $239.88 | $239.88 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,202.26 Typical High $4,570.88 | Facility | None | $524.81 | $1,202.26 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $575.44 | Professional | None | $346.74 | $407.38 | $575.44 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $1,348.96 Typical High $1,737.80 | Facility | None | $302.00 | $1,348.96 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $288.40 | Professional | None | $257.04 | $257.04 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,479.11 Typical High $2,290.87 | Facility | None | $398.11 | $1,479.11 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $426.58 | Professional | None | $234.42 | $251.19 | $426.58 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $398.11 Median $1,479.11 Typical High $2,238.72 | Facility | None | $398.11 | $1,479.11 | $2,238.72 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $426.58 | Professional | None | $245.47 | $251.19 | $426.58 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Facility Modifier None Typical Low $758.58 Median $794.33 Typical High $912.01 | Facility | None | $758.58 | $794.33 | $912.01 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | None | $50.12 | $70.79 | $70.79 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $389.05 | Professional | None | $199.53 | $251.19 | $389.05 |
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 $120.23 Median $120.23 Typical High $158.49 | Professional | 52 · Reduced service | $120.23 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $63.10 | Professional | 53 · Discontinued | $48.98 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $234.42 | Professional | 54 · Surgery only | $181.97 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $47.86 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $31.62 |
Where Ohio sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 19th of 51
$347
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.