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 $1,659.59 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,659.59 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $1,778.28 | Professional | None | $346.74 | $346.74 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,778.28 Typical High $7,585.78 | Facility | None | $588.84 | $1,778.28 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $588.84 | Professional | None | $338.84 | $398.11 | $588.84 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $831.76 Typical High $1,096.48 | Facility | None | $436.52 | $831.76 | $1,096.48 |
CareSource Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $416.87 | Professional | None | $363.08 | $363.08 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $954.99 Typical High $1,995.26 | Facility | None | $489.78 | $954.99 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $724.44 | Professional | None | $338.84 | $371.54 | $724.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $954.99 Typical High $1,995.26 | Facility | None | $512.86 | $954.99 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $691.83 | Professional | None | $338.84 | $371.54 | $691.83 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $478.63 | Professional | None | $251.19 | $316.23 | $478.63 |
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 $323.59 Median $323.59 Typical High $371.54 | Professional | None | $323.59 | $323.59 | $371.54 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $5,888.44 | Facility | None | $691.83 | $1,445.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $616.60 | Professional | None | $295.12 | $407.38 | $616.60 |
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 $173.78 Median $173.78 Typical High $229.09 | Professional | 52 · Reduced service | $173.78 | $173.78 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $93.33 | Professional | 53 · Discontinued | $69.18 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $346.74 | Professional | 54 · Surgery only | $263.03 | $263.03 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $69.18 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $46.77 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $46.77 |
Where Ohio sits
The same service costs 4.8 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· 39th of 51
$398
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.