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 $501.19 Median $3,235.94 Typical High $12,589.25 | Facility | None | $501.19 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $398.11 Typical High $457.09 | Professional | None | $154.88 | $398.11 | $457.09 |
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 $154.88 Median $251.19 Typical High $467.74 | Professional | None | $154.88 | $251.19 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $831.76 Typical High $1,096.48 | Facility | None | $194.98 | $831.76 | $1,096.48 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $186.21 | Professional | None | $165.96 | $165.96 | $186.21 |
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 $162.18 Median $331.13 Typical High $549.54 | Professional | None | $162.18 | $331.13 | $549.54 |
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 $162.18 Median $331.13 Typical High $537.03 | Professional | None | $162.18 | $331.13 | $537.03 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $457.09 Typical High $724.44 | Professional | None | $245.47 | $457.09 | $724.44 |
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 $144.54 Median $218.78 Typical High $537.03 | Professional | None | $144.54 | $218.78 | $537.03 |
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 $147.91 Median $309.03 Typical High $501.19 | Professional | None | $147.91 | $309.03 | $501.19 |
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 $77.62 Median $199.53 Typical High $204.17 | Professional | 52 · Reduced service | $77.62 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $79.43 Typical High $81.28 | Professional | 53 · Discontinued | $30.90 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $117.49 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $23.44 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $39.81 Typical High $40.74 | Professional | 56 · Pre-op care only | $15.49 | $39.81 | $40.74 |
Where Ohio sits
The same service costs 4.5 times more in Alaska than in Washington, DC. 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· 41st of 51
$331
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.