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 $288.40 Median $1,995.26 Typical High $10,964.78 | Facility | None | $288.40 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $457.09 | Professional | None | $104.71 | $154.88 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $251.19 | Professional | None | $141.25 | $141.25 | $251.19 |
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 $91.20 Median $109.65 Typical High $190.55 | Professional | None | $91.20 | $109.65 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $97.72 Median $128.82 Typical High $144.54 | Facility | None | $97.72 | $128.82 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $141.25 Typical High $616.60 | Facility | None | $66.07 | $141.25 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $281.84 | Professional | None | $125.89 | $181.97 | $281.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $66.07 Median $144.54 Typical High $776.25 | Facility | None | $66.07 | $144.54 | $776.25 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $281.84 | Professional | None | $125.89 | $181.97 | $281.84 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $309.03 | Professional | None | $154.88 | $204.17 | $309.03 |
SummaCare Setting Facility Modifier None Typical Low $61.66 Median $64.57 Typical High $72.44 | Facility | None | $61.66 | $64.57 | $72.44 |
SummaCare Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $190.55 | Professional | None | $107.15 | $154.88 | $190.55 |
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 $91.20 Median $151.36 Typical High $263.03 | Professional | None | $91.20 | $151.36 | $263.03 |
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 $51.29 Median $77.62 Typical High $89.13 | Professional | 52 · Reduced service | $51.29 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $30.90 Typical High $35.48 | Professional | 53 · Discontinued | $20.89 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $117.49 Typical High $131.83 | Professional | 54 · Surgery only | $77.62 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $23.44 Typical High $26.30 | Professional | 55 · Aftercare only | $15.49 | $23.44 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $15.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.23 | $15.49 | $17.78 |
Where Ohio sits
The same service costs 3.3 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· 41st of 51
$170
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.