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 $1,288.25 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,288.25 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $4,168.69 | Professional | None | $354.81 | $354.81 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $2,137.96 Typical High $7,079.46 | Facility | None | $562.34 | $2,137.96 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $575.44 | Professional | None | $302.00 | $354.81 | $575.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $537.03 Typical High $870.96 | Professional | 50 · Both sides | $446.68 | $537.03 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $2,454.71 Typical High $3,162.28 | Facility | None | $436.52 | $2,454.71 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $2,570.40 Typical High $4,168.69 | Facility | None | $363.08 | $2,570.40 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $724.44 | Professional | None | $338.84 | $389.05 | $724.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $2,570.40 Typical High $4,073.80 | Facility | None | $389.05 | $2,570.40 | $4,073.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $724.44 | Professional | None | $338.84 | $389.05 | $724.44 |
Molina Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $562.34 | Professional | None | $331.13 | $416.87 | $562.34 |
SummaCare Setting Facility Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,659.59 | Facility | None | $1,412.54 | $1,479.11 | $1,659.59 |
SummaCare Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $512.86 | Professional | None | $323.59 | $323.59 | $512.86 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $851.14 | Professional | None | $338.84 | $416.87 | $851.14 |
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 $177.83 Median $177.83 Typical High $602.56 | Professional | 52 · Reduced service | $177.83 | $177.83 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $239.88 | Professional | 53 · Discontinued | $70.79 | $70.79 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $912.01 | Professional | 54 · Surgery only | $263.03 | $263.03 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $181.97 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $120.23 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $120.23 |
Where Ohio sits
The same service costs 7.8 times more in Oklahoma than in New York. 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· 48th of 51
$417
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.