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 $81.28 Median $147.91 Typical High $269.15 | Facility | None | $81.28 | $147.91 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $81.28 Typical High $162.18 | Professional | None | $38.02 | $81.28 | $162.18 |
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 $20.89 Median $25.12 Typical High $37.15 | Professional | None | $20.89 | $25.12 | $37.15 |
Aultcare Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $67.61 Typical High $125.89 | Professional | None | $52.48 | $67.61 | $125.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $138.04 Median $380.19 Typical High $707.95 | Facility | None | $138.04 | $380.19 | $707.95 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $125.89 | Professional | None | $53.70 | $67.61 | $125.89 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
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 $28.84 Median $67.61 Typical High $97.72 | Professional | None | $28.84 | $67.61 | $97.72 |
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 $39.81 Median $39.81 Typical High $56.23 | Professional | 52 · Reduced service | $39.81 | $39.81 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $22.39 | Professional | 53 · Discontinued | $16.22 | $16.22 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $60.26 Typical High $83.18 | Professional | 54 · Surgery only | $60.26 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $16.98 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $11.22 |
Where Ohio sits
The same service costs 4.5 times more in Alaska than in Ohio. 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· 51st of 51
$31.62
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.