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 $1,122.02 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,122.02 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $154.88 Typical High $3,548.13 | Professional | None | $144.54 | $154.88 | $3,548.13 |
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 $162.18 Median $190.55 Typical High $288.40 | Professional | None | $162.18 | $190.55 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $158.49 Median $204.17 Typical High $218.78 | Facility | None | $158.49 | $204.17 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $186.21 Typical High $302.00 | Facility | None | $158.49 | $186.21 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $380.19 | Professional | None | $169.82 | $186.21 | $380.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $158.49 Median $186.21 Typical High $288.40 | Facility | None | $158.49 | $186.21 | $288.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $380.19 | Professional | None | $173.78 | $186.21 | $380.19 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $275.42 | Professional | None | $162.18 | $208.93 | $275.42 |
SummaCare Setting Facility Modifier None Typical Low $85.11 Median $91.20 Typical High $102.33 | Facility | None | $85.11 | $91.20 | $102.33 |
SummaCare Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $263.03 | Professional | None | $165.96 | $165.96 | $263.03 |
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 $162.18 Median $204.17 Typical High $407.38 | Professional | None | $162.18 | $204.17 | $407.38 |
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 $72.44 Median $72.44 Typical High $389.05 | Professional | 52 · Reduced service | $72.44 | $72.44 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $154.88 | Professional | 53 · Discontinued | $28.84 | $28.84 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $588.84 | Professional | 54 · Surgery only | $107.15 | $107.15 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $117.49 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $77.62 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $77.62 |
Where Ohio sits
The same service costs 3.2 times more in Alaska 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
$204
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.