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 $154.88 Median $316.23 Typical High $12,022.64 | Facility | None | $154.88 | $316.23 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $380.19 | Professional | None | $87.10 | $123.03 | $380.19 |
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 $69.18 Median $112.20 Typical High $181.97 | Professional | None | $69.18 | $112.20 | $181.97 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $102.33 Median $165.96 Typical High $269.15 | Professional | 50 · Both sides | $102.33 | $165.96 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $63.10 Median $81.28 Typical High $104.71 | Facility | None | $63.10 | $81.28 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $79.43 Typical High $158.49 | Facility | None | $58.88 | $79.43 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $245.47 | Professional | None | $81.28 | $125.89 | $245.47 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $79.43 Typical High $158.49 | Facility | None | $58.88 | $79.43 | $158.49 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $251.19 | Professional | None | $81.28 | $125.89 | $251.19 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $165.96 | Professional | None | $91.20 | $120.23 | $165.96 |
SummaCare Setting Facility Modifier None Typical Low $38.02 Median $39.81 Typical High $45.71 | Facility | None | $38.02 | $39.81 | $45.71 |
SummaCare Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $165.96 | Professional | None | $79.43 | $125.89 | $165.96 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,311.31 | Facility | None | $363.08 | $691.83 | $3,311.31 |
United Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $218.78 | Professional | None | $79.43 | $123.03 | $218.78 |
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 $43.65 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $43.65 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $17.38 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $91.20 Typical High $91.20 | Professional | 54 · Surgery only | $64.57 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $12.88 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.71 | $12.02 | $12.02 |
Where Ohio sits
The same service costs 3.2 times more in Wisconsin than in Texas. 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· 43rd of 51
$123
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.