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 $331.13 Median $1,995.26 Typical High $10,964.78 | Facility | None | $331.13 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $575.44 | Professional | None | $120.23 | $162.18 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
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 $104.71 Median $128.82 Typical High $199.53 | Professional | None | $104.71 | $128.82 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $89.13 Median $114.82 Typical High $162.18 | Facility | None | $89.13 | $114.82 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $123.03 Typical High $616.60 | Facility | None | $66.07 | $123.03 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $288.40 | Professional | None | $144.54 | $190.55 | $288.40 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $66.07 Median $117.49 Typical High $616.60 | Facility | None | $66.07 | $117.49 | $616.60 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $288.40 | Professional | None | $144.54 | $190.55 | $288.40 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $309.03 | Professional | None | $162.18 | $208.93 | $309.03 |
SummaCare Setting Facility Modifier None Typical Low $53.70 Median $56.23 Typical High $64.57 | Facility | None | $53.70 | $56.23 | $64.57 |
SummaCare Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $223.87 | Professional | None | $120.23 | $154.88 | $223.87 |
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 $107.15 Median $165.96 Typical High $288.40 | Professional | None | $107.15 | $165.96 | $288.40 |
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 $60.26 Median $81.28 Typical High $93.33 | Professional | 52 · Reduced service | $60.26 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $32.36 Typical High $37.15 | Professional | 53 · Discontinued | $23.99 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $123.03 Typical High $141.25 | Professional | 54 · Surgery only | $89.13 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $24.55 Typical High $28.18 | Professional | 55 · Aftercare only | $18.20 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $16.22 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.02 | $16.22 | $18.62 |
Where Ohio sits
The same service costs 3.6 times more in Alaska 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· 41st of 51
$178
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.