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 $79.43 Median $288.40 Typical High $10,715.19 | Facility | None | $79.43 | $288.40 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $87.10 Typical High $162.18 | Professional | None | $43.65 | $87.10 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $128.82 | Professional | None | $26.30 | $26.30 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $1,621.81 Typical High $4,073.80 | Facility | None | $776.25 | $1,621.81 | $4,073.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $102.33 Typical High $144.54 | Professional | None | $57.54 | $102.33 | $144.54 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $125.89 | Professional | None | $79.43 | $87.10 | $125.89 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $77.62 Typical High $147.91 | Professional | None | $42.66 | $77.62 | $147.91 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $549.54 Median $870.96 Typical High $1,737.80 | Facility | None | $549.54 | $870.96 | $1,737.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $42.66 Median $77.62 Typical High $141.25 | Professional | None | $42.66 | $77.62 | $141.25 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $97.72 Typical High $158.49 | Professional | None | $77.62 | $97.72 | $158.49 |
SummaCare Setting Professional Modifier None Typical Low $39.81 Median $51.29 Typical High $107.15 | Professional | None | $39.81 | $51.29 | $107.15 |
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 $42.66 Median $87.10 Typical High $144.54 | Professional | None | $42.66 | $87.10 | $144.54 |
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 $21.88 Median $42.66 Typical High $45.71 | Professional | 52 · Reduced service | $21.88 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $17.38 Typical High $18.20 | Professional | 53 · Discontinued | $8.71 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $64.57 Typical High $69.18 | Professional | 54 · Surgery only | $32.36 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $12.88 Typical High $13.80 | Professional | 55 · Aftercare only | $6.46 | $12.88 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $8.71 Typical High $9.12 | Professional | 56 · Pre-op care only | $4.37 | $8.71 | $9.12 |
Where Ohio sits
The same service costs 2.5 times more in North Carolina 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· 39th of 51
$87.10
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.