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 $446.68 Median $2,454.71 Typical High $12,589.25 | Facility | None | $446.68 | $2,454.71 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $912.01 | Professional | None | $162.18 | $162.18 | $912.01 |
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 $181.97 Median $213.80 Typical High $354.81 | Professional | None | $181.97 | $213.80 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $158.49 Median $204.17 Typical High $251.19 | Facility | None | $158.49 | $204.17 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $177.83 Typical High $354.81 | Facility | None | $58.88 | $177.83 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $436.52 | Professional | None | $194.98 | $213.80 | $436.52 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $177.83 Typical High $354.81 | Facility | None | $58.88 | $177.83 | $354.81 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $436.52 | Professional | None | $194.98 | $208.93 | $436.52 |
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 $186.21 Median $186.21 Typical High $295.12 | Professional | None | $186.21 | $186.21 | $295.12 |
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 $181.97 Median $229.09 Typical High $457.09 | Professional | None | $181.97 | $229.09 | $457.09 |
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 $81.28 Median $81.28 Typical High $398.11 | Professional | 52 · Reduced service | $81.28 | $81.28 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $158.49 | Professional | 53 · Discontinued | $32.36 | $32.36 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $602.56 | Professional | 54 · Surgery only | $123.03 | $123.03 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $120.23 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $79.43 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $79.43 |
Where Ohio sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 44th of 51
$214
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.