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 $436.52 Median $3,235.94 Typical High $12,589.25 | Facility | None | $436.52 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $123.03 Typical High $467.74 | Professional | None | $50.12 | $123.03 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $16,595.87 Median $16,595.87 Typical High $18,620.87 | Facility | None | $16,595.87 | $16,595.87 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $109.65 Typical High $234.42 | Professional | None | $44.67 | $109.65 | $234.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $63.10 Median $158.49 Typical High $354.81 | Professional | 50 · Both sides | $63.10 | $158.49 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $21,379.62 | Facility | None | $72.44 | $72.44 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $107.15 Typical High $208.93 | Professional | None | $47.86 | $107.15 | $208.93 |
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 $47.86 Median $107.15 Typical High $199.53 | Professional | None | $47.86 | $107.15 | $199.53 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $218.78 | Professional | None | $112.20 | $158.49 | $218.78 |
SummaCare Setting Professional Modifier None Typical Low $47.86 Median $125.89 Typical High $162.18 | Professional | None | $47.86 | $125.89 | $162.18 |
United Setting Facility Modifier None Typical Low $478.63 Median $1,445.44 Typical High $3,715.35 | Facility | None | $478.63 | $1,445.44 | $3,715.35 |
United Setting Professional Modifier None Typical Low $51.29 Median $114.82 Typical High $295.12 | Professional | None | $51.29 | $114.82 | $295.12 |
4 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 $25.12 Median $61.66 Typical High $79.43 | Professional | 52 · Reduced service | $25.12 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $24.55 Typical High $31.62 | Professional | 53 · Discontinued | $10.00 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $18.20 Typical High $23.44 | Professional | 55 · Aftercare only | $7.59 | $18.20 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $12.30 Typical High $15.85 | Professional | 56 · Pre-op care only | $5.01 | $12.30 | $15.85 |
Where Ohio sits
The same service costs 2.7 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· 29th of 51
$123
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.