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 $1,621.81 Median $7,244.36 Typical High $12,589.25 | Facility | None | $1,621.81 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $9,120.11 | Professional | None | $338.84 | $338.84 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,230.27 Typical High $4,677.35 | Facility | None | $562.34 | $1,230.27 | $4,677.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $588.84 | Professional | None | $316.23 | $380.19 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $562.34 Typical High $870.96 | Professional | 50 · Both sides | $478.63 | $562.34 | $870.96 |
CareSource Setting Facility Modifier None Typical Low $416.87 Median $1,584.89 Typical High $2,089.30 | Facility | None | $416.87 | $1,584.89 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,819.70 Typical High $2,754.23 | Facility | None | $549.54 | $1,819.70 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $724.44 | Professional | None | $323.59 | $380.19 | $724.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,691.53 | Facility | None | $602.56 | $1,819.70 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $724.44 | Professional | None | $323.59 | $380.19 | $724.44 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $501.19 | Professional | None | $295.12 | $371.54 | $501.19 |
SummaCare Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,047.13 | Facility | None | $891.25 | $933.25 | $1,047.13 |
SummaCare Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $501.19 | Professional | None | $309.03 | $309.03 | $501.19 |
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 $331.13 Median $426.58 Typical High $812.83 | Professional | None | $331.13 | $426.58 | $812.83 |
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 $169.82 Median $169.82 Typical High $588.84 | Professional | 52 · Reduced service | $169.82 | $169.82 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $234.42 | Professional | 53 · Discontinued | $67.61 | $67.61 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $870.96 | Professional | 54 · Surgery only | $257.04 | $257.04 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $177.83 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $117.49 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $117.49 |
Where Ohio sits
The same service costs 4.7 times more in Alaska 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· 46th of 51
$407
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.