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 $2,398.83 Median $9,772.37 Typical High $12,882.50 | Facility | None | $2,398.83 | $9,772.37 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $1,698.24 | Professional | None | $398.11 | $398.11 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $8,128.31 | Facility | None | $954.99 | $2,344.23 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $575.44 | Professional | None | $363.08 | $426.58 | $575.44 |
CareSource Setting Facility Modifier None Typical Low $489.78 Median $2,630.27 Typical High $3,388.44 | Facility | None | $489.78 | $2,630.27 | $3,388.44 |
CareSource Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $478.63 | Professional | None | $416.87 | $416.87 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $4,786.30 Typical High $7,413.10 | Facility | None | $1,288.25 | $4,786.30 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $758.58 | Professional | None | $389.05 | $426.58 | $758.58 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,318.26 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,318.26 | $4,897.79 | $6,918.31 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $758.58 | Professional | None | $389.05 | $426.58 | $758.58 |
Molina Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $575.44 | Professional | None | $302.00 | $380.19 | $575.44 |
SummaCare Setting Facility Modifier None Typical Low $2,344.23 Median $2,454.71 Typical High $2,818.38 | Facility | None | $2,344.23 | $2,454.71 | $2,818.38 |
SummaCare Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $436.52 | Professional | None | $371.54 | $371.54 | $436.52 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $676.08 | Professional | None | $338.84 | $436.52 | $676.08 |
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 $199.53 Median $199.53 Typical High $263.03 | Professional | 52 · Reduced service | $199.53 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $104.71 | Professional | 53 · Discontinued | $79.43 | $79.43 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $398.11 | Professional | 54 · Surgery only | $302.00 | $302.00 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $79.43 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $52.48 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $52.48 |
Where Ohio sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 45th of 51
$427
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.