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 $549.54 Median $3,235.94 Typical High $12,589.25 | Facility | None | $549.54 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $218.78 Typical High $1,995.26 | Professional | None | $109.65 | $218.78 | $1,995.26 |
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 $114.82 Median $208.93 Typical High $363.08 | Professional | None | $114.82 | $208.93 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $194.98 Typical High $363.08 | Professional | None | $93.33 | $194.98 | $363.08 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $93.33 Median $194.98 Typical High $363.08 | Professional | None | $93.33 | $194.98 | $363.08 |
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 $75.86 Median $138.04 Typical High $204.17 | Professional | None | $75.86 | $138.04 | $204.17 |
United Setting Facility Modifier None Typical Low $831.76 Median $977.24 Typical High $1,380.38 | Facility | None | $831.76 | $977.24 | $1,380.38 |
United Setting Professional Modifier None Typical Low $95.50 Median $194.98 Typical High $380.19 | Professional | None | $95.50 | $194.98 | $380.19 |
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 $54.95 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $54.95 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $21.88 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $162.18 Typical High $162.18 | Professional | 54 · Surgery only | $83.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $16.60 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $10.96 | $21.88 | $21.88 |
Where Ohio sits
The same service costs 3.4 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· 37th of 51
$200
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.