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 $295.12 Median $295.12 Typical High $426.58 | Facility | None | $295.12 | $295.12 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $426.58 | Professional | None | $295.12 | $295.12 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $331.13 Median $707.95 Typical High $1,949.84 | Facility | None | $331.13 | $707.95 | $1,949.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $489.78 | Professional | None | $295.12 | $295.12 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $977.24 | Facility | None | $724.44 | $724.44 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $363.08 | Professional | None | $338.84 | $338.84 | $363.08 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $977.24 | Facility | None | $724.44 | $724.44 | $977.24 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $363.08 | Professional | None | $338.84 | $338.84 | $363.08 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $50.12 | Professional | None | $39.81 | $50.12 | $50.12 |
SummaCare Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $645.65 | Professional | None | $338.84 | $354.81 | $645.65 |
United Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $426.58 | Professional | None | $302.00 | $346.74 | $426.58 |
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 $147.91 Median $147.91 Typical High $213.80 | Professional | 52 · Reduced service | $147.91 | $147.91 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $85.11 | Professional | 53 · Discontinued | $58.88 | $58.88 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $64.57 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $42.66 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $42.66 |
Where Ohio sits
The same service costs 22.9 times more in Arizona than in South Carolina. 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· 19th of 51
$339
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.