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 $125.89 Median $10,232.93 Typical High $13,803.84 | Facility | None | $125.89 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $389.05 | Professional | None | $104.71 | $104.71 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $158.49 Median $354.81 Typical High $1,659.59 | Facility | None | $158.49 | $354.81 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $158.49 | Professional | None | $91.20 | $107.15 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $125.89 | Professional | None | $112.20 | $112.20 | $125.89 |
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 $102.33 Median $114.82 Typical High $186.21 | Professional | None | $102.33 | $114.82 | $186.21 |
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 $102.33 Median $114.82 Typical High $186.21 | Professional | None | $102.33 | $114.82 | $186.21 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $74.13 Typical High $112.20 | Professional | None | $57.54 | $74.13 | $112.20 |
SummaCare Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $114.82 | Professional | None | $97.72 | $97.72 | $114.82 |
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 |
United Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $177.83 | Professional | None | $91.20 | $114.82 | $177.83 |
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 $52.48 Median $52.48 Typical High $70.79 | Professional | 52 · Reduced service | $52.48 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $28.18 | Professional | 53 · Discontinued | $20.89 | $20.89 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $104.71 | Professional | 54 · Surgery only | $79.43 | $79.43 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $21.38 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $14.13 |
Where Ohio sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 42nd of 51
$110
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.