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 $151.36 Median $10,232.93 Typical High $13,803.84 | Facility | None | $151.36 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $9,120.11 | Professional | None | $114.82 | $114.82 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,311.31 Typical High $6,309.57 | Facility | None | $741.31 | $3,311.31 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $204.17 | Professional | None | $100.00 | $117.49 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $2,691.53 | Facility | None | $501.19 | $707.95 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $275.42 | Professional | None | $125.89 | $165.96 | $275.42 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $2,691.53 | Facility | None | $501.19 | $707.95 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $275.42 | Professional | None | $125.89 | $165.96 | $275.42 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $223.87 | Professional | None | $123.03 | $165.96 | $223.87 |
SummaCare Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $181.97 | Professional | None | $120.23 | $120.23 | $181.97 |
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 $123.03 Median $165.96 Typical High $309.03 | Professional | None | $123.03 | $165.96 | $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 $57.54 Median $57.54 Typical High $257.04 | Professional | 52 · Reduced service | $57.54 | $57.54 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $102.33 | Professional | 53 · Discontinued | $22.91 | $22.91 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $380.19 | Professional | 54 · Surgery only | $85.11 | $85.11 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $75.86 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $51.29 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $51.29 |
Where Ohio sits
The same service costs 3.9 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· 37th of 51
$166
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.