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 $6,456.54 Median $10,715.19 Typical High $13,803.84 | Facility | None | $6,456.54 | $10,715.19 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $5,623.41 Median $6,456.54 Typical High $9,332.54 | Professional | None | $5,623.41 | $6,456.54 | $9,332.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $6,606.93 Typical High $13,803.84 | Facility | None | $891.25 | $6,606.93 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,467.37 Median $4,073.80 Typical High $5,754.40 | Professional | None | $3,467.37 | $4,073.80 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $724.44 | Professional | None | $316.23 | $457.09 | $724.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $724.44 | Professional | None | $316.23 | $457.09 | $724.44 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | None | $50.12 | $70.79 | $70.79 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
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 $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | 52 · Reduced service | $3,235.94 | $3,235.94 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 53 · Discontinued | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | 54 · Surgery only | $4,786.30 | $4,786.30 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 55 · Aftercare only | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 56 · Pre-op care only | $645.65 | $645.65 | $645.65 |
Where Ohio sits
The same service costs 218.8 times more in Alabama than in Hawaii. 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· 9th of 51
$4,074
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.