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 $77.62 Median $10,232.93 Typical High $13,803.84 | Facility | None | $77.62 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $77.62 Typical High $234.42 | Professional | None | $64.57 | $77.62 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $363.08 Median $794.33 Typical High $3,311.31 | Facility | None | $363.08 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $123.03 | Professional | None | $63.10 | $79.43 | $123.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $91.20 Median $120.23 Typical High $181.97 | Professional | 50 · Both sides | $91.20 | $120.23 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $31.62 Median $41.69 Typical High $79.43 | Facility | None | $31.62 | $41.69 | $79.43 |
CareSource Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $50.12 Typical High $100.00 | Facility | None | $36.31 | $50.12 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $144.54 | Professional | None | $56.23 | $75.86 | $144.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $36.31 Median $50.12 Typical High $100.00 | Facility | None | $36.31 | $50.12 | $100.00 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $144.54 | Professional | None | $56.23 | $75.86 | $144.54 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $102.33 | Professional | None | $53.70 | $69.18 | $102.33 |
SummaCare Setting Facility Modifier None Typical Low $19.50 Median $20.42 Typical High $23.44 | Facility | None | $19.50 | $20.42 | $23.44 |
SummaCare Setting Professional Modifier None Typical Low $56.23 Median $79.43 Typical High $93.33 | Professional | None | $56.23 | $79.43 | $93.33 |
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 $56.23 Median $72.44 Typical High $125.89 | Professional | None | $56.23 | $72.44 | $125.89 |
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 $32.36 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $32.36 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $12.88 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $58.88 Typical High $58.88 | Professional | 54 · Surgery only | $48.98 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $9.77 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.46 | $7.76 | $7.76 |
Where Ohio sits
The same service costs 3.8 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· 38th of 51
$77.62
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.