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 $83.18 Median $1,995.26 Typical High $10,964.78 | Facility | None | $83.18 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $100.00 Typical High $338.84 | Professional | None | $26.92 | $100.00 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $831.76 Typical High $3,715.35 | Facility | None | $371.54 | $831.76 | $3,715.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $33.11 Typical High $48.98 | Professional | None | $26.92 | $33.11 | $48.98 |
CareSource Setting Facility Modifier None Typical Low $36.31 Median $85.11 Typical High $109.65 | Facility | None | $36.31 | $85.11 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $165.96 Typical High $1,479.11 | Facility | None | $93.33 | $165.96 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $102.33 Typical High $173.78 | Professional | None | $33.88 | $102.33 | $173.78 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $93.33 Median $165.96 Typical High $1,479.11 | Facility | None | $93.33 | $165.96 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $33.88 Median $102.33 Typical High $173.78 | Professional | None | $33.88 | $102.33 | $173.78 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $208.93 | Professional | None | $107.15 | $138.04 | $208.93 |
SummaCare Setting Facility Modifier None Typical Low $48.98 Median $51.29 Typical High $58.88 | Facility | None | $48.98 | $51.29 | $58.88 |
SummaCare Setting Professional Modifier None Typical Low $26.92 Median $77.62 Typical High $134.90 | Professional | None | $26.92 | $77.62 | $134.90 |
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 $24.55 Median $77.62 Typical High $199.53 | Professional | None | $24.55 | $77.62 | $199.53 |
1 more rate 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 54 · Surgery only Typical Low $20.42 Median $74.13 Typical High $89.13 | Professional | 54 · Surgery only | $20.42 | $74.13 | $89.13 |
Where Ohio sits
The same service costs 5.1 times more in Iowa than in Kentucky. 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· 34th of 51
$100
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.