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 $446.68 Median $3,235.94 Typical High $12,589.25 | Facility | None | $446.68 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $223.87 Typical High $1,023.29 | Professional | None | $104.71 | $223.87 | $1,023.29 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $1,621.81 Typical High $4,073.80 | Facility | None | $776.25 | $1,621.81 | $4,073.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $229.09 | Professional | None | $104.71 | $125.89 | $229.09 |
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 $128.82 Median $245.47 Typical High $398.11 | Professional | None | $128.82 | $245.47 | $398.11 |
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 $128.82 Median $245.47 Typical High $389.05 | Professional | None | $128.82 | $245.47 | $389.05 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $380.19 | Professional | None | $199.53 | $275.42 | $380.19 |
SummaCare Setting Professional Modifier None Typical Low $104.71 Median $245.47 Typical High $323.59 | Professional | None | $104.71 | $245.47 | $323.59 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $2,511.89 Typical High $4,265.80 | Facility | None | $1,148.15 | $2,511.89 | $4,265.80 |
United Setting Professional Modifier None Typical Low $125.89 Median $257.04 Typical High $446.68 | Professional | None | $125.89 | $257.04 | $446.68 |
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 $52.48 Median $112.20 Typical High $158.49 | Professional | 52 · Reduced service | $52.48 | $112.20 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $44.67 Typical High $63.10 | Professional | 53 · Discontinued | $20.89 | $44.67 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $165.96 Typical High $234.42 | Professional | 54 · Surgery only | $79.43 | $165.96 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $33.11 Typical High $47.86 | Professional | 55 · Aftercare only | $15.85 | $33.11 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $22.39 Typical High $31.62 | Professional | 56 · Pre-op care only | $10.47 | $22.39 | $31.62 |
Where Ohio sits
The same service costs 3.4 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· 40th of 51
$224
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.