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 $190.55 Median $1,995.26 Typical High $10,964.78 | Facility | None | $190.55 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $158.49 Typical High $2,344.23 | Professional | None | $69.18 | $158.49 | $2,344.23 |
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 $74.13 Median $151.36 Typical High $245.47 | Professional | None | $74.13 | $151.36 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna 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 Professional Modifier None Typical Low $58.88 Median $144.54 Typical High $269.15 | Professional | None | $58.88 | $144.54 | $269.15 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $58.88 Median $144.54 Typical High $257.04 | Professional | None | $58.88 | $144.54 | $257.04 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $269.15 | Professional | None | $144.54 | $186.21 | $269.15 |
SummaCare Setting Professional Modifier None Typical Low $47.86 Median $117.49 Typical High $169.82 | Professional | None | $47.86 | $117.49 | $169.82 |
United Setting Facility Modifier None Typical Low $416.87 Median $478.63 Typical High $676.08 | Facility | None | $416.87 | $478.63 | $676.08 |
United Setting Professional Modifier None Typical Low $56.23 Median $131.83 Typical High $275.42 | Professional | None | $56.23 | $131.83 | $275.42 |
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 $34.67 Median $79.43 Typical High $83.18 | Professional | 52 · Reduced service | $34.67 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $31.62 Typical High $33.11 | Professional | 53 · Discontinued | $13.80 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $120.23 Typical High $123.03 | Professional | 54 · Surgery only | $51.29 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $23.99 Typical High $24.55 | Professional | 55 · Aftercare only | $10.23 | $23.99 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $15.85 Typical High $16.60 | Professional | 56 · Pre-op care only | $6.92 | $15.85 | $16.60 |
Where Ohio sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 25th of 51
$158
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.