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 $1,174.90 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,174.90 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $1,122.02 | Professional | None | $257.04 | $257.04 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $2,238.72 Typical High $7,079.46 | Facility | None | $758.58 | $2,238.72 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $371.54 | Professional | None | $229.09 | $269.15 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $316.23 Median $2,630.27 Typical High $3,388.44 | Facility | None | $316.23 | $2,630.27 | $3,388.44 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $302.00 | Professional | None | $269.15 | $269.15 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $4,570.88 Typical High $7,244.36 | Facility | None | $588.84 | $4,570.88 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $478.63 | Professional | None | $245.47 | $275.42 | $478.63 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $588.84 Median $4,570.88 Typical High $7,244.36 | Facility | None | $588.84 | $4,570.88 | $7,244.36 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $467.74 | Professional | None | $245.47 | $275.42 | $467.74 |
Molina Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $426.58 | Professional | None | $218.78 | $281.84 | $426.58 |
SummaCare Setting Facility Modifier None Typical Low $4,897.79 Median $5,128.61 Typical High $5,888.44 | Facility | None | $4,897.79 | $5,128.61 | $5,888.44 |
SummaCare Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $275.42 | Professional | None | $234.42 | $234.42 | $275.42 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,786.30 | Facility | None | $501.19 | $977.24 | $4,786.30 |
United Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $436.52 | Professional | None | $218.78 | $281.84 | $436.52 |
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 $125.89 Median $125.89 Typical High $165.96 | Professional | 52 · Reduced service | $125.89 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $66.07 | Professional | 53 · Discontinued | $51.29 | $51.29 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $245.47 | Professional | 54 · Surgery only | $190.55 | $190.55 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $48.98 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $33.11 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $33.11 |
Where Ohio sits
The same service costs 4.3 times more in Alaska than in Florida. 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· 44th of 51
$269
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.