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 $3,235.94 Typical High $12,589.25 | Facility | None | $331.13 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $144.54 Typical High $457.09 | Professional | None | $60.26 | $144.54 | $457.09 |
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 $53.70 Median $109.65 Typical High $208.93 | Professional | None | $53.70 | $109.65 | $208.93 |
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 $64.57 Median $131.83 Typical High $229.09 | Professional | None | $64.57 | $131.83 | $229.09 |
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 $64.57 Median $134.90 Typical High $218.78 | Professional | None | $64.57 | $134.90 | $218.78 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $218.78 | Professional | None | $112.20 | $158.49 | $218.78 |
SummaCare Setting Professional Modifier None Typical Low $53.70 Median $144.54 Typical High $190.55 | Professional | None | $53.70 | $144.54 | $190.55 |
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 $64.57 Median $141.25 Typical High $302.00 | Professional | None | $64.57 | $141.25 | $302.00 |
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 $30.20 Median $72.44 Typical High $91.20 | Professional | 52 · Reduced service | $30.20 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $29.51 Typical High $36.31 | Professional | 53 · Discontinued | $12.02 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $109.65 Typical High $138.04 | Professional | 54 · Surgery only | $44.67 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $21.88 Typical High $27.54 | Professional | 55 · Aftercare only | $8.91 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $14.45 Typical High $18.20 | Professional | 56 · Pre-op care only | $6.03 | $14.45 | $18.20 |
Where Ohio sits
The same service costs 3.7 times more in Wisconsin 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· 39th of 51
$135
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.