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 $72.44 Median $457.09 Typical High $10,715.19 | Facility | None | $72.44 | $457.09 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $70.79 Typical High $346.74 | Professional | None | $38.90 | $70.79 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $81.28 Typical High $117.49 | Professional | None | $48.98 | $81.28 | $117.49 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $77.62 Median $112.20 Typical High $169.82 | Professional | 50 · Both sides | $77.62 | $112.20 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $46.77 Median $53.70 Typical High $61.66 | Facility | None | $46.77 | $53.70 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $79.43 Typical High $1,479.11 | Facility | None | $45.71 | $79.43 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $77.62 Typical High $165.96 | Professional | None | $47.86 | $77.62 | $165.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $45.71 Median $79.43 Typical High $1,479.11 | Facility | None | $45.71 | $79.43 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $47.86 Median $77.62 Typical High $165.96 | Professional | None | $47.86 | $77.62 | $165.96 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $104.71 | Professional | None | $53.70 | $69.18 | $104.71 |
SummaCare Setting Facility Modifier None Typical Low $23.99 Median $25.12 Typical High $28.84 | Facility | None | $23.99 | $25.12 | $28.84 |
SummaCare Setting Professional Modifier None Typical Low $39.81 Median $60.26 Typical High $87.10 | Professional | None | $39.81 | $60.26 | $87.10 |
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 $35.48 Median $83.18 Typical High $190.55 | Professional | None | $35.48 | $83.18 | $190.55 |
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 $19.50 Median $34.67 Typical High $46.77 | Professional | 52 · Reduced service | $19.50 | $34.67 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $14.13 Typical High $18.62 | Professional | 53 · Discontinued | $7.76 | $14.13 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $52.48 Typical High $70.79 | Professional | 54 · Surgery only | $29.51 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $10.47 Typical High $14.13 | Professional | 55 · Aftercare only | $5.89 | $10.47 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $7.08 Typical High $9.33 | Professional | 56 · Pre-op care only | $3.89 | $7.08 | $9.33 |
Where Ohio sits
The same service costs 3.2 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· 45th of 51
$77.62
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.