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 $60.26 Median $165.96 Typical High $12,022.64 | Facility | None | $60.26 | $165.96 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $60.26 Typical High $190.55 | Professional | None | $41.69 | $60.26 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $63.10 | Professional | None | $53.70 | $53.70 | $63.10 |
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 $39.81 Median $51.29 Typical High $77.62 | Professional | None | $39.81 | $51.29 | $77.62 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $54.95 Median $77.62 Typical High $117.49 | Professional | 50 · Both sides | $54.95 | $77.62 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $50.12 Median $537.03 Typical High $812.83 | Facility | None | $50.12 | $537.03 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $794.33 | Facility | None | $50.12 | $66.07 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $58.88 Typical High $95.50 | Professional | None | $38.90 | $58.88 | $95.50 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $630.96 | Facility | None | $50.12 | $66.07 | $630.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $37.15 Median $57.54 Typical High $95.50 | Professional | None | $37.15 | $57.54 | $95.50 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $67.61 Typical High $102.33 | Professional | None | $48.98 | $67.61 | $102.33 |
SummaCare Setting Professional Modifier None Typical Low $38.90 Median $64.57 Typical High $74.13 | Professional | None | $38.90 | $64.57 | $74.13 |
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 $38.90 Median $52.48 Typical High $93.33 | Professional | None | $38.90 | $52.48 | $93.33 |
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 $20.89 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $20.89 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $8.32 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $45.71 Typical High $45.71 | Professional | 54 · Surgery only | $31.62 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $6.31 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.17 | $6.03 | $6.03 |
Where Ohio sits
The same service costs 3.8 times more in Alaska than in Maryland. 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
$60.26
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.