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 $102.33 Median $102.33 Typical High $3,715.35 | Professional | None | $102.33 | $102.33 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $851.14 Typical High $3,388.44 | Facility | None | $389.05 | $851.14 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $169.82 | Professional | None | $81.28 | $97.72 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $141.25 Median $363.08 Typical High $467.74 | Facility | None | $141.25 | $363.08 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $457.09 Typical High $1,479.11 | Facility | None | $354.81 | $457.09 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $302.00 | Professional | None | $120.23 | $147.91 | $302.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $363.08 Median $457.09 Typical High $1,479.11 | Facility | None | $363.08 | $457.09 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $323.59 | Professional | None | $120.23 | $147.91 | $323.59 |
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 $199.53 Median $208.93 Typical High $239.88 | Facility | None | $199.53 | $208.93 | $239.88 |
SummaCare Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $165.96 | Professional | None | $112.20 | $112.20 | $165.96 |
United Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $3,311.31 | Facility | None | $363.08 | $691.83 | $3,311.31 |
United Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $281.84 | Professional | None | $104.71 | $141.25 | $281.84 |
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 $51.29 Median $51.29 Typical High $234.42 | Professional | 52 · Reduced service | $51.29 | $51.29 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $93.33 | Professional | 53 · Discontinued | $20.42 | $20.42 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $346.74 | Professional | 54 · Surgery only | $77.62 | $77.62 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $70.79 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $46.77 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $46.77 |
Where Ohio sits
The same service costs 4.4 times more in Alaska 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· 40th of 51
$151
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.