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 $380.19 Median $1,995.26 Typical High $10,964.78 | Facility | None | $380.19 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $295.12 Typical High $1,584.89 | Professional | None | $138.04 | $295.12 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $16,595.87 Median $16,595.87 Typical High $18,620.87 | Facility | None | $16,595.87 | $16,595.87 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $302.00 | Professional | None | $138.04 | $162.18 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $549.54 | Professional | None | $173.78 | $323.59 | $549.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $549.54 | Professional | None | $177.83 | $323.59 | $549.54 |
Molina Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $602.56 | Professional | None | $309.03 | $436.52 | $602.56 |
SummaCare Setting Professional Modifier None Typical Low $147.91 Median $363.08 Typical High $478.63 | Professional | None | $147.91 | $363.08 | $478.63 |
United Setting Facility Modifier None Typical Low $478.63 Median $1,445.44 Typical High $3,715.35 | Facility | None | $478.63 | $1,445.44 | $3,715.35 |
United Setting Professional Modifier None Typical Low $173.78 Median $338.84 Typical High $602.56 | Professional | None | $173.78 | $338.84 | $602.56 |
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 $69.18 Median $147.91 Typical High $208.93 | Professional | 52 · Reduced service | $69.18 | $147.91 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $58.88 Typical High $83.18 | Professional | 53 · Discontinued | $27.54 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $223.87 Typical High $316.23 | Professional | 54 · Surgery only | $104.71 | $223.87 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $44.67 Typical High $63.10 | Professional | 55 · Aftercare only | $20.89 | $44.67 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $29.51 Typical High $41.69 | Professional | 56 · Pre-op care only | $13.80 | $29.51 | $41.69 |
Where Ohio sits
The same service costs 3.3 times more in Alaska than in Virginia. 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· 41st of 51
$302
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.