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 $331.13 Median $3,019.95 Typical High $12,022.64 | Facility | None | $331.13 | $3,019.95 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $457.09 | Professional | None | $120.23 | $120.23 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,174.90 Typical High $4,570.88 | Facility | None | $524.81 | $1,174.90 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $107.15 | Professional | None | $63.10 | $74.13 | $107.15 |
CareSource Setting Facility Modifier None Typical Low $147.91 Median $630.96 Typical High $831.76 | Facility | None | $147.91 | $630.96 | $831.76 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | None | $125.89 | $125.89 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $724.44 Typical High $2,398.83 | Facility | None | $537.03 | $724.44 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $223.87 | Professional | None | $120.23 | $125.89 | $223.87 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $537.03 Median $724.44 Typical High $2,398.83 | Facility | None | $537.03 | $724.44 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $123.03 Median $125.89 Typical High $213.80 | Professional | None | $123.03 | $125.89 | $213.80 |
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 $338.84 Median $354.81 Typical High $407.38 | Facility | None | $338.84 | $354.81 | $407.38 |
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 $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $194.98 | Professional | None | $100.00 | $125.89 | $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 $60.26 Median $60.26 Typical High $79.43 | Professional | 52 · Reduced service | $60.26 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $31.62 | Professional | 53 · Discontinued | $23.99 | $23.99 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $117.49 | Professional | 54 · Surgery only | $91.20 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $23.44 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $15.85 |
Where Ohio sits
The same service costs 6.0 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· 44th of 51
$120
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.