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 $186.21 Median $1,318.26 Typical High $10,715.19 | Facility | None | $186.21 | $1,318.26 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $389.05 Typical High $1,096.48 | Professional | None | $67.61 | $389.05 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,659.59 | $3,311.31 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $354.81 Typical High $602.56 | Professional | None | $87.10 | $354.81 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $245.47 Typical High $588.84 | Professional | None | $70.79 | $245.47 | $588.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $70.79 Median $245.47 Typical High $575.44 | Professional | None | $70.79 | $245.47 | $575.44 |
Molina Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $660.69 | Professional | None | $338.84 | $467.74 | $660.69 |
SummaCare Setting Professional Modifier None Typical Low $63.10 Median $389.05 Typical High $501.19 | Professional | None | $63.10 | $389.05 | $501.19 |
United Setting Facility Modifier None Typical Low $3,548.13 Median $6,606.93 Typical High $10,964.78 | Facility | None | $3,548.13 | $6,606.93 | $10,964.78 |
United Setting Professional Modifier None Typical Low $74.13 Median $323.59 Typical High $645.65 | Professional | None | $74.13 | $323.59 | $645.65 |
6 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 $33.88 Median $194.98 Typical High $245.47 | Professional | 52 · Reduced service | $33.88 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $77.62 Typical High $97.72 | Professional | 53 · Discontinued | $13.49 | $77.62 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $295.12 Typical High $380.19 | Professional | 54 · Surgery only | $51.29 | $295.12 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $58.88 Typical High $74.13 | Professional | 55 · Aftercare only | $10.23 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $38.90 Typical High $48.98 | Professional | 56 · Pre-op care only | $6.76 | $38.90 | $48.98 |
Ambetter Setting Professional Modifier 22 · Increased work Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 22 · Increased work | $45.71 | $45.71 | $45.71 |
Where Ohio sits
The same service costs 5.6 times more in Wisconsin than in Maryland. 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· 28th of 51
$372
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.