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 $1,862.09 Median $5,128.61 Typical High $6,309.57 | Facility | None | $1,862.09 | $5,128.61 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $5,128.61 | Professional | None | $1,862.09 | $1,862.09 | $5,128.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $436.52 Median $758.58 Typical High $3,890.45 | Facility | None | $436.52 | $758.58 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $3,019.95 | Professional | None | $1,318.26 | $1,318.26 | $3,019.95 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $5,888.44 | Facility | None | $4,365.16 | $4,365.16 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,187.76 | Professional | None | $2,041.74 | $2,041.74 | $2,187.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $5,888.44 | Facility | None | $4,365.16 | $4,365.16 | $5,888.44 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,187.76 | Professional | None | $2,041.74 | $2,041.74 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $1,905.46 Median $2,454.71 Typical High $2,884.03 | Professional | None | $1,905.46 | $2,454.71 | $2,884.03 |
SummaCare Setting Professional Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $3,801.89 | Professional | None | $1,862.09 | $2,137.96 | $3,801.89 |
United Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $2,630.27 | Professional | None | $1,862.09 | $2,187.76 | $2,630.27 |
4 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 $933.25 Median $933.25 Typical High $1,513.56 | Professional | 52 · Reduced service | $933.25 | $933.25 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $616.60 | Professional | 53 · Discontinued | $371.54 | $371.54 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $457.09 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $309.03 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $309.03 |
Where Ohio sits
The same service costs 1.9 times more in Arizona than in Hawaii. 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· 50th of 51
$1,622
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.