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 $1,122.02 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,122.02 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $977.24 | Professional | None | $223.87 | $223.87 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $4,570.88 | Facility | None | $524.81 | $1,122.02 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $354.81 | Professional | None | $223.87 | $263.03 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $275.42 Median $616.60 Typical High $794.33 | Facility | None | $275.42 | $616.60 | $794.33 |
CareSource Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $269.15 | Professional | None | $234.42 | $234.42 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $741.31 Typical High $2,951.21 | Facility | None | $549.54 | $741.31 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $354.81 | Professional | None | $218.78 | $239.88 | $354.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $741.31 Typical High $2,951.21 | Facility | None | $549.54 | $741.31 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $354.81 | Professional | None | $218.78 | $239.88 | $354.81 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $295.12 | Professional | None | $134.90 | $186.21 | $295.12 |
SummaCare Setting Facility Modifier None Typical Low $338.84 Median $354.81 Typical High $407.38 | Facility | None | $338.84 | $354.81 | $407.38 |
SummaCare Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | None | $208.93 | $208.93 | $245.47 |
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 $190.55 Median $257.04 Typical High $389.05 | Professional | None | $190.55 | $257.04 | $389.05 |
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 $112.20 Median $112.20 Typical High $144.54 | Professional | 52 · Reduced service | $112.20 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $57.54 | Professional | 53 · Discontinued | $44.67 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $218.78 | Professional | 54 · Surgery only | $165.96 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $43.65 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $28.84 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $28.84 |
Where Ohio sits
The same service costs 4.7 times more in Wyoming 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· 44th of 51
$240
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.