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 $776.25 Median $776.25 Typical High $2,344.23 | Facility | None | $776.25 | $776.25 | $2,344.23 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $3,388.44 | Professional | None | $776.25 | $776.25 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $1,288.25 Typical High $1,995.26 | Facility | None | $812.83 | $1,288.25 | $1,995.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,380.38 Typical High $1,698.24 | Professional | None | $831.76 | $1,380.38 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,398.83 | Facility | None | $1,778.28 | $1,778.28 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $977.24 | Professional | None | $831.76 | $831.76 | $977.24 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,398.83 | Facility | None | $1,778.28 | $1,778.28 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $977.24 | Professional | None | $831.76 | $831.76 | $977.24 |
United Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
4 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 $389.05 Median $389.05 Typical High $1,659.59 | Professional | 52 · Reduced service | $389.05 | $389.05 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $676.08 | Professional | 53 · Discontinued | $154.88 | $154.88 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $501.19 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $338.84 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $338.84 |
Where Ohio sits
The same service costs 295.1 times more in Alabama than in Montana. 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· 6th of 51
$1,202
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.