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 $338.84 Median $3,235.94 Typical High $12,589.25 | Facility | None | $338.84 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $213.80 Typical High $239.88 | Professional | None | $79.43 | $213.80 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $954.99 Typical High $3,388.44 | Facility | None | $389.05 | $954.99 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $239.88 | Professional | None | $85.11 | $128.82 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $97.72 Median $467.74 Typical High $616.60 | Facility | None | $97.72 | $467.74 | $616.60 |
CareSource Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $95.50 | Professional | None | $83.18 | $83.18 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $549.54 Typical High $1,479.11 | Facility | None | $363.08 | $549.54 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $186.21 Typical High $281.84 | Professional | None | $81.28 | $186.21 | $281.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $549.54 Typical High $1,479.11 | Facility | None | $389.05 | $549.54 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $81.28 Median $186.21 Typical High $281.84 | Professional | None | $81.28 | $186.21 | $281.84 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $234.42 Typical High $371.54 | Professional | None | $181.97 | $234.42 | $371.54 |
SummaCare Setting Facility Modifier None Typical Low $263.03 Median $275.42 Typical High $316.23 | Facility | None | $263.03 | $275.42 | $316.23 |
SummaCare Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $275.42 | Professional | None | $75.86 | $114.82 | $275.42 |
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 $74.13 Median $147.91 Typical High $245.47 | Professional | None | $74.13 | $147.91 | $245.47 |
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 $39.81 Median $104.71 Typical High $107.15 | Professional | 52 · Reduced service | $39.81 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $15.85 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $158.49 Typical High $162.18 | Professional | 54 · Surgery only | $58.88 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $31.62 Typical High $32.36 | Professional | 55 · Aftercare only | $12.02 | $31.62 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $7.94 | $21.38 | $21.38 |
Where Ohio sits
The same service costs 4.1 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· 34th of 51
$174
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.