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 $169.82 Median $575.44 Typical High $10,715.19 | Facility | None | $169.82 | $575.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $169.82 Typical High $309.03 | Professional | None | $89.13 | $169.82 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $1,230.27 Typical High $4,466.84 | Facility | None | $537.03 | $1,230.27 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $245.47 | Professional | None | $128.82 | $165.96 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $1,348.96 Typical High $1,737.80 | Facility | None | $109.65 | $1,348.96 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $107.15 | Professional | None | $93.33 | $93.33 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,513.56 Typical High $2,290.87 | Facility | None | $489.78 | $1,513.56 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $154.88 Typical High $251.19 | Professional | None | $91.20 | $154.88 | $251.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $1,513.56 Typical High $2,187.76 | Facility | None | $512.86 | $1,513.56 | $2,187.76 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $56.23 Median $117.49 Typical High $234.42 | Professional | None | $56.23 | $117.49 | $234.42 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $269.15 | Professional | None | $131.83 | $169.82 | $269.15 |
SummaCare Setting Facility Modifier None Typical Low $741.31 Median $776.25 Typical High $870.96 | Facility | None | $741.31 | $776.25 | $870.96 |
SummaCare Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $223.87 | Professional | None | $85.11 | $128.82 | $223.87 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $83.18 Median $138.04 Typical High $223.87 | Professional | None | $83.18 | $138.04 | $223.87 |
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 $44.67 Median $85.11 Typical High $87.10 | Professional | 52 · Reduced service | $44.67 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $33.88 Typical High $34.67 | Professional | 53 · Discontinued | $17.78 | $33.88 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $125.89 Typical High $131.83 | Professional | 54 · Surgery only | $67.61 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $25.70 Typical High $26.30 | Professional | 55 · Aftercare only | $13.49 | $25.70 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $16.98 Typical High $17.38 | Professional | 56 · Pre-op care only | $8.91 | $16.98 | $17.38 |
Where Ohio sits
The same service costs 3.6 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· 36th of 51
$158
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.