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 $1,862.09 Median $4,570.88 Typical High $12,589.25 | Facility | None | $1,862.09 | $4,570.88 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $5,248.07 | Professional | None | $194.98 | $194.98 | $5,248.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $7,585.78 | Facility | None | $630.96 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $1,584.89 Typical High $2,089.30 | Facility | None | $218.78 | $1,584.89 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,819.70 Typical High $2,818.38 | Facility | None | $549.54 | $1,819.70 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $1,862.09 | Professional | None | $154.88 | $208.93 | $1,862.09 |
Medical Mutual of Ohio 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 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $1,862.09 | Professional | None | $158.49 | $204.17 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $50.12 | Professional | None | $30.20 | $30.20 | $50.12 |
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 |
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 $114.82 Median $724.44 Typical High $1,122.02 | Professional | None | $114.82 | $724.44 | $1,122.02 |
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 $97.72 Median $97.72 Typical High $117.49 | Professional | 52 · Reduced service | $97.72 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $46.77 | Professional | 53 · Discontinued | $38.90 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $181.97 | Professional | 54 · Surgery only | $147.91 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $35.48 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $23.44 |
Where Ohio sits
The same service costs 53.7 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· 28th of 51
$891
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.