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 $436.52 Median $6,760.83 Typical High $8,317.64 | Facility | None | $436.52 | $6,760.83 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $2,454.71 Typical High $2,454.71 | Professional | None | $407.38 | $2,454.71 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $3,801.89 Typical High $5,888.44 | Facility | None | $2,344.23 | $3,801.89 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $1,905.46 | Professional | None | $117.49 | $138.04 | $1,905.46 |
CareSource Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $7,762.47 | Facility | None | $5,888.44 | $5,888.44 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,884.03 | Professional | None | $2,691.53 | $2,691.53 | $2,884.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $7,762.47 | Facility | None | $5,888.44 | $5,888.44 | $7,762.47 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,884.03 | Professional | None | $2,691.53 | $2,691.53 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $1,479.11 | Professional | None | $977.24 | $1,380.38 | $1,479.11 |
SummaCare Setting Professional Modifier None Typical Low $2,754.23 Median $2,818.38 Typical High $5,248.07 | Professional | None | $2,754.23 | $2,818.38 | $5,248.07 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
United Setting Professional Modifier None Typical Low $2,511.89 Median $2,884.03 Typical High $3,467.37 | Professional | None | $2,511.89 | $2,884.03 | $3,467.37 |
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 $204.17 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $204.17 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $83.18 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $61.66 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $40.74 | $245.47 | $245.47 |
Where Ohio sits
The same service costs 25.1 times more in Arizona than in Montana. 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· 26th of 51
$2,570
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.