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 $1,737.80 Median $3,235.94 Typical High $12,589.25 | Facility | None | $1,737.80 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $4,168.69 | Professional | None | $416.87 | $416.87 | $4,168.69 |
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 $363.08 Median $467.74 Typical High $758.58 | Professional | None | $363.08 | $467.74 | $758.58 |
CareSource Setting Facility Modifier None Typical Low $213.80 Median $275.42 Typical High $645.65 | Facility | None | $213.80 | $275.42 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $338.84 Typical High $1,479.11 | Facility | None | $218.78 | $338.84 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $1,047.13 | Professional | None | $457.09 | $549.54 | $1,047.13 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $218.78 Median $338.84 Typical High $1,479.11 | Facility | None | $218.78 | $338.84 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $1,071.52 | Professional | None | $457.09 | $549.54 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $776.25 | Professional | None | $457.09 | $575.44 | $776.25 |
SummaCare Setting Facility Modifier None Typical Low $117.49 Median $123.03 Typical High $138.04 | Facility | None | $117.49 | $123.03 | $138.04 |
SummaCare Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $758.58 | Professional | None | $478.63 | $478.63 | $758.58 |
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 $426.58 Median $562.34 Typical High $1,202.26 | Professional | None | $426.58 | $562.34 | $1,202.26 |
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 $208.93 Median $208.93 Typical High $912.01 | Professional | 52 · Reduced service | $208.93 | $208.93 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $363.08 | Professional | 53 · Discontinued | $83.18 | $83.18 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $1,348.96 | Professional | 54 · Surgery only | $316.23 | $316.23 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $269.15 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $181.97 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $181.97 |
Where Ohio sits
The same service costs 3.5 times more in Alaska than in Arkansas. 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· 37th of 51
$550
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.