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 $1,000.00 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,000.00 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $616.60 | Professional | None | $131.83 | $131.83 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $1,148.15 Typical High $4,466.84 | Facility | None | $467.74 | $1,148.15 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $346.74 | Professional | None | $165.96 | $218.78 | $346.74 |
CareSource Setting Facility Modifier None Typical Low $165.96 Median $831.76 Typical High $1,096.48 | Facility | None | $165.96 | $831.76 | $1,096.48 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $158.49 | Professional | None | $138.04 | $138.04 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $954.99 Typical High $1,621.81 | Facility | None | $363.08 | $954.99 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $338.84 | Professional | None | $128.82 | $141.25 | $338.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $954.99 Typical High $1,621.81 | Facility | None | $389.05 | $954.99 | $1,621.81 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $131.83 Median $141.25 Typical High $338.84 | Professional | None | $131.83 | $141.25 | $338.84 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $162.18 | Professional | None | $83.18 | $104.71 | $162.18 |
SummaCare Setting Facility Modifier None Typical Low $457.09 Median $478.63 Typical High $549.54 | Facility | None | $457.09 | $478.63 | $549.54 |
SummaCare Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $144.54 | Professional | None | $123.03 | $123.03 | $144.54 |
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 $114.82 Median $186.21 Typical High $269.15 | Professional | None | $114.82 | $186.21 | $269.15 |
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 $66.07 Median $66.07 Typical High $100.00 | Professional | 52 · Reduced service | $66.07 | $66.07 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $39.81 | Professional | 53 · Discontinued | $26.30 | $26.30 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $147.91 | Professional | 54 · Surgery only | $97.72 | $97.72 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $29.51 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $19.95 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $19.95 |
Where Ohio sits
The same service costs 5.4 times more in Alaska 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· 38th of 51
$170
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.