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 $177.83 Median $478.63 Typical High $10,715.19 | Facility | None | $177.83 | $478.63 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $416.87 | Professional | None | $95.50 | $134.90 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $323.59 | Professional | None | $109.65 | $131.83 | $323.59 |
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 $83.18 Median $104.71 Typical High $158.49 | Professional | None | $83.18 | $104.71 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $81.28 Median $104.71 Typical High $131.83 | Facility | None | $81.28 | $104.71 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $114.82 Typical High $616.60 | Facility | None | $66.07 | $114.82 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $239.88 | Professional | None | $117.49 | $158.49 | $239.88 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $66.07 Median $117.49 Typical High $794.33 | Facility | None | $66.07 | $117.49 | $794.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $239.88 | Professional | None | $117.49 | $158.49 | $239.88 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $263.03 | Professional | None | $131.83 | $169.82 | $263.03 |
SummaCare Setting Facility Modifier None Typical Low $50.12 Median $52.48 Typical High $58.88 | Facility | None | $50.12 | $52.48 | $58.88 |
SummaCare Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $245.47 | Professional | None | $97.72 | $154.88 | $245.47 |
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 $83.18 Median $134.90 Typical High $229.09 | Professional | None | $83.18 | $134.90 | $229.09 |
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 $47.86 Median $67.61 Typical High $75.86 | Professional | 52 · Reduced service | $47.86 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $26.92 Typical High $30.20 | Professional | 53 · Discontinued | $19.05 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $102.33 Typical High $114.82 | Professional | 54 · Surgery only | $72.44 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $20.42 Typical High $22.91 | Professional | 55 · Aftercare only | $14.45 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $13.49 Typical High $15.14 | Professional | 56 · Pre-op care only | $9.55 | $13.49 | $15.14 |
Where Ohio sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 39th of 51
$148
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.