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 $316.23 Median $2,454.71 Typical High $12,589.25 | Facility | None | $316.23 | $2,454.71 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $134.90 Typical High $371.54 | Professional | None | $125.89 | $134.90 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $131.83 | Professional | None | $117.49 | $117.49 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $177.83 | Professional | None | $83.18 | $100.00 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $218.78 | Professional | None | $114.82 | $125.89 | $218.78 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $645.65 | Facility | None | $354.81 | $354.81 | $645.65 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $281.84 | Professional | None | $117.49 | $147.91 | $281.84 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $213.80 | Professional | None | $114.82 | $147.91 | $213.80 |
SummaCare Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $181.97 | Professional | None | $123.03 | $144.54 | $181.97 |
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 $89.13 Median $131.83 Typical High $288.40 | Professional | None | $89.13 | $131.83 | $288.40 |
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 $61.66 Median $61.66 Typical High $154.88 | Professional | 52 · Reduced service | $61.66 | $61.66 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $61.66 | Professional | 53 · Discontinued | $25.12 | $25.12 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $234.42 | Professional | 54 · Surgery only | $93.33 | $93.33 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $46.77 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $30.90 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $30.90 |
Where Ohio sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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· 48th of 51
$129
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.