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 $93.33 Median $134.90 Typical High $12,589.25 | Facility | None | $93.33 | $134.90 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $40.74 Typical High $134.90 | Professional | None | $33.88 | $40.74 | $134.90 |
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 $18.62 Median $40.74 Typical High $77.62 | Professional | None | $18.62 | $40.74 | $77.62 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $40.74 Median $54.95 Typical High $79.43 | Professional | 50 · Both sides | $40.74 | $54.95 | $79.43 |
CareSource Setting Facility Modifier None Typical Low $40.74 Median $537.03 Typical High $812.83 | Facility | None | $40.74 | $537.03 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
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 $29.51 Median $42.66 Typical High $70.79 | Professional | None | $29.51 | $42.66 | $70.79 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $794.33 | Facility | None | $50.12 | $66.07 | $794.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $29.51 Median $41.69 Typical High $70.79 | Professional | None | $29.51 | $41.69 | $70.79 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $33.11 Typical High $48.98 | Professional | None | $25.12 | $33.11 | $48.98 |
SummaCare Setting Professional Modifier None Typical Low $29.51 Median $41.69 Typical High $47.86 | Professional | None | $29.51 | $41.69 | $47.86 |
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 $30.90 Median $38.90 Typical High $67.61 | Professional | None | $30.90 | $38.90 | $67.61 |
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 $16.98 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $16.98 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $6.76 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $30.90 Typical High $30.90 | Professional | 54 · Surgery only | $25.12 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $5.13 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.07 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.39 | $4.07 | $4.07 |
Where Ohio sits
The same service costs 3.8 times more in Alaska than in Utah. 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· 44th of 51
$40.74
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.