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 $61.66 Median $2,630.27 Typical High $10,964.78 | Facility | None | $61.66 | $2,630.27 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $28.18 Typical High $158.49 | Professional | None | $22.39 | $28.18 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $25.12 Median $29.51 Typical High $29.51 | Professional | None | $25.12 | $29.51 | $29.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $831.76 Typical High $3,311.31 | Facility | None | $371.54 | $831.76 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.20 Median $23.99 Typical High $45.71 | Professional | None | $18.20 | $23.99 | $45.71 |
CareSource Setting Facility Modifier None Typical Low $13.49 Median $17.38 Typical High $44.67 | Facility | None | $13.49 | $17.38 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $28.84 Typical High $1,995.26 | Facility | None | $15.85 | $28.84 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $34.67 Typical High $57.54 | Professional | None | $27.54 | $34.67 | $57.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $15.85 Median $28.84 Typical High $1,995.26 | Facility | None | $15.85 | $28.84 | $1,995.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $27.54 Median $34.67 Typical High $57.54 | Professional | None | $27.54 | $34.67 | $57.54 |
Molina Setting Professional Modifier None Typical Low $12.02 Median $14.13 Typical High $25.70 | Professional | None | $12.02 | $14.13 | $25.70 |
SummaCare Setting Facility Modifier None Typical Low $16.60 Median $17.38 Typical High $19.95 | Facility | None | $16.60 | $17.38 | $19.95 |
SummaCare Setting Professional Modifier None Typical Low $21.88 Median $33.88 Typical High $43.65 | Professional | None | $21.88 | $33.88 | $43.65 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $17.38 Median $30.90 Typical High $54.95 | Professional | None | $17.38 | $30.90 | $54.95 |
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 $10.96 Median $14.13 Typical High $16.22 | Professional | 52 · Reduced service | $10.96 | $14.13 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $5.62 Typical High $6.46 | Professional | 53 · Discontinued | $4.47 | $5.62 | $6.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.60 Median $21.38 Typical High $24.55 | Professional | 54 · Surgery only | $16.60 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $4.27 Typical High $4.90 | Professional | 55 · Aftercare only | $3.31 | $4.27 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.82 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.24 | $2.82 | $3.24 |
Where Ohio sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 42nd of 51
$33.11
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.