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 $954.99 Median $4,365.16 Typical High $12,589.25 | Facility | None | $954.99 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $776.25 Typical High $2,630.27 | Professional | None | $204.17 | $776.25 | $2,630.27 |
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 $251.19 Median $776.25 Typical High $1,288.25 | Professional | None | $251.19 | $776.25 | $1,288.25 |
Aultcare Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
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 $213.80 Median $602.56 Typical High $1,230.27 | Professional | None | $213.80 | $602.56 | $1,230.27 |
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 $213.80 Median $602.56 Typical High $1,174.90 | Professional | None | $213.80 | $602.56 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,318.26 | Professional | None | $676.08 | $933.25 | $1,318.26 |
SummaCare Setting Professional Modifier None Typical Low $190.55 Median $794.33 Typical High $1,023.29 | Professional | None | $190.55 | $794.33 | $1,023.29 |
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 $223.87 Median $741.31 Typical High $1,412.54 | Professional | None | $223.87 | $741.31 | $1,412.54 |
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 $102.33 Median $389.05 Typical High $489.78 | Professional | 52 · Reduced service | $102.33 | $389.05 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $154.88 Typical High $194.98 | Professional | 53 · Discontinued | $40.74 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $588.84 Typical High $741.31 | Professional | 54 · Surgery only | $154.88 | $588.84 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $117.49 Typical High $147.91 | Professional | 55 · Aftercare only | $30.90 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $77.62 Typical High $97.72 | Professional | 56 · Pre-op care only | $20.42 | $77.62 | $97.72 |
Where Ohio sits
The same service costs 5.4 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
$776
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.