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 $190.55 Median $3,235.94 Typical High $12,589.25 | Facility | None | $190.55 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $72.44 Typical High $2,630.27 | Professional | None | $38.90 | $72.44 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $61.66 Typical High $97.72 | Professional | None | $38.02 | $61.66 | $97.72 |
CareSource Setting Facility Modifier None Typical Low $41.69 Median $47.86 Typical High $53.70 | Facility | None | $41.69 | $47.86 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $58.88 Typical High $549.54 | Facility | None | $44.67 | $58.88 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $66.07 Typical High $134.90 | Professional | None | $38.02 | $66.07 | $134.90 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $44.67 Median $58.88 Typical High $549.54 | Facility | None | $44.67 | $58.88 | $549.54 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $38.02 Median $70.79 Typical High $138.04 | Professional | None | $38.02 | $70.79 | $138.04 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $109.65 | Professional | None | $64.57 | $81.28 | $109.65 |
SummaCare Setting Facility Modifier None Typical Low $23.99 Median $25.12 Typical High $28.18 | Facility | None | $23.99 | $25.12 | $28.18 |
SummaCare Setting Professional Modifier None Typical Low $34.67 Median $74.13 Typical High $95.50 | Professional | None | $34.67 | $74.13 | $95.50 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $40.74 Median $66.07 Typical High $123.03 | Professional | None | $40.74 | $66.07 | $123.03 |
1 more rate 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 54 · Surgery only Typical Low $29.51 Median $53.70 Typical High $53.70 | Professional | 54 · Surgery only | $29.51 | $53.70 | $53.70 |
Where Ohio sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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
$67.61
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.