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 $758.58 Median $758.58 Typical High $3,162.28 | Facility | None | $758.58 | $758.58 | $3,162.28 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $3,019.95 | Professional | None | $758.58 | $758.58 | $3,019.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $5,011.87 Typical High $11,481.54 | Facility | None | $741.31 | $5,011.87 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,380.38 Typical High $1,905.46 | Professional | None | $912.01 | $1,380.38 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $218.78 Typical High $309.03 | Professional | 80 · Assistant surgeon | $147.91 | $218.78 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $190.55 Typical High $269.15 | Professional | AS · PA/NP assist | $128.82 | $190.55 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,949.84 | Professional | None | $851.14 | $1,000.00 | $1,949.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,949.84 | Professional | None | $851.14 | $1,000.00 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,412.54 | Professional | None | $831.76 | $1,071.52 | $1,412.54 |
SummaCare Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,318.26 | Professional | None | $891.25 | $891.25 | $1,318.26 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,778.28 | Professional | None | $891.25 | $1,071.52 | $1,778.28 |
3 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 $380.19 Median $380.19 Typical High $1,513.56 | Professional | 52 · Reduced service | $380.19 | $380.19 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $602.56 | Professional | 53 · Discontinued | $151.36 | $151.36 | $602.56 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $1,096.48 Median $1,174.90 Typical High $1,174.90 | Professional | GC · Resident with teaching physician | $1,096.48 | $1,174.90 | $1,174.90 |
Where Ohio sits
The same service costs 3.4 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· 30th of 51
$1,175
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.