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 $229.09 Median $6,025.60 Typical High $12,589.25 | Facility | None | $229.09 | $6,025.60 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $9,332.54 | Professional | None | $107.15 | $131.83 | $9,332.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $1,202.26 Typical High $4,786.30 | Facility | None | $645.65 | $1,202.26 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $223.87 | Professional | None | $117.49 | $138.04 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $165.96 Median $1,621.81 Typical High $2,089.30 | Facility | None | $165.96 | $1,621.81 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,862.09 Typical High $3,388.44 | Facility | None | $758.58 | $1,862.09 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $281.84 | Professional | None | $128.82 | $147.91 | $281.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $794.33 Median $1,862.09 Typical High $3,388.44 | Facility | None | $794.33 | $1,862.09 | $3,388.44 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $281.84 | Professional | None | $128.82 | $147.91 | $281.84 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $223.87 | Professional | None | $128.82 | $165.96 | $223.87 |
SummaCare Setting Facility Modifier None Typical Low $1,778.28 Median $1,862.09 Typical High $2,137.96 | Facility | None | $1,778.28 | $1,862.09 | $2,137.96 |
SummaCare Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $190.55 | Professional | None | $123.03 | $123.03 | $190.55 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $309.03 | Professional | None | $120.23 | $151.36 | $309.03 |
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 $53.70 Median $53.70 Typical High $269.15 | Professional | 52 · Reduced service | $53.70 | $53.70 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $107.15 | Professional | 53 · Discontinued | $21.38 | $21.38 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $398.11 | Professional | 54 · Surgery only | $81.28 | $81.28 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $79.43 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $53.70 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $53.70 |
Where Ohio sits
The same service costs 10.7 times more in Oklahoma than in New York. 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
$170
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.