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 $389.05 Typical High $10,715.19 | Facility | None | $125.89 | $389.05 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $114.82 Typical High $346.74 | Professional | None | $69.18 | $114.82 | $346.74 |
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 $56.23 Median $85.11 Typical High $154.88 | Professional | None | $56.23 | $85.11 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $21,379.62 | Facility | None | $102.33 | $102.33 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $107.15 Typical High $204.17 | Professional | None | $67.61 | $107.15 | $204.17 |
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 $67.61 Median $107.15 Typical High $204.17 | Professional | None | $67.61 | $107.15 | $204.17 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $162.18 | Professional | None | $85.11 | $120.23 | $162.18 |
SummaCare Setting Professional Modifier None Typical Low $63.10 Median $114.82 Typical High $151.36 | Professional | None | $63.10 | $114.82 | $151.36 |
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 $72.44 Median $109.65 Typical High $234.42 | Professional | None | $72.44 | $109.65 | $234.42 |
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 $34.67 Median $57.54 Typical High $75.86 | Professional | 52 · Reduced service | $34.67 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $22.91 Typical High $30.20 | Professional | 53 · Discontinued | $13.80 | $22.91 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $87.10 Typical High $112.20 | Professional | 54 · Surgery only | $51.29 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $17.38 Typical High $22.91 | Professional | 55 · Aftercare only | $10.23 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $11.48 Typical High $15.14 | Professional | 56 · Pre-op care only | $6.92 | $11.48 | $15.14 |
Where Ohio sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 44th of 51
$100
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.