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 $63.10 Median $251.19 Typical High $10,232.93 | Facility | None | $63.10 | $251.19 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $95.50 Typical High $281.84 | Professional | None | $34.67 | $95.50 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $20.89 Median $33.88 Typical High $102.33 | Professional | None | $20.89 | $33.88 | $102.33 |
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 $19.95 Median $34.67 Typical High $79.43 | Professional | None | $19.95 | $34.67 | $79.43 |
CareSource Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $123.03 | Professional | None | $100.00 | $100.00 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $74.13 Typical High $123.03 | Professional | None | $30.20 | $74.13 | $123.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $218.78 Median $380.19 Typical High $602.56 | Facility | None | $218.78 | $380.19 | $602.56 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $30.20 Median $74.13 Typical High $123.03 | Professional | None | $30.20 | $74.13 | $123.03 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $158.49 | Professional | None | $85.11 | $112.20 | $158.49 |
SummaCare Setting Professional Modifier None Typical Low $32.36 Median $63.10 Typical High $117.49 | Professional | None | $32.36 | $63.10 | $117.49 |
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 $26.30 Median $47.86 Typical High $97.72 | Professional | None | $26.30 | $47.86 | $97.72 |
3 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 54 · Surgery only Typical Low $25.70 Median $70.79 Typical High $70.79 | Professional | 54 · Surgery only | $25.70 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $5.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $3.47 | $9.33 | $9.33 |
Where Ohio sits
The same service costs 2.8 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· 42nd of 51
$63.10
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.