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 $4,466.84 Median $10,000.00 Typical High $38,018.94 | Facility | None | $4,466.84 | $10,000.00 | $38,018.94 |
Aetna Setting Professional Modifier None Typical Low $4,786.30 Median $16,595.87 Typical High $22,387.21 | Professional | None | $4,786.30 | $16,595.87 | $22,387.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $5,128.61 Typical High $21,877.62 | Facility | None | $1,479.11 | $5,128.61 | $21,877.62 |
Cigna Setting Facility Modifier None Typical Low $12,022.64 Median $16,218.10 Typical High $23,442.29 | Facility | None | $12,022.64 | $16,218.10 | $23,442.29 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $12,022.64 Median $14,454.40 Typical High $22,908.68 | Facility | None | $12,022.64 | $14,454.40 | $22,908.68 |
SummaCare Setting Facility Modifier None Typical Low $6,606.93 Median $6,918.31 Typical High $7,943.28 | Facility | None | $6,606.93 | $6,918.31 | $7,943.28 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,265.80 Typical High $22,387.21 | Facility | None | $1,071.52 | $4,265.80 | $22,387.21 |
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 $8,317.64 Median $8,317.64 Typical High $11,220.18 | Professional | 52 · Reduced service | $8,317.64 | $8,317.64 | $11,220.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,311.31 Median $3,311.31 Typical High $4,466.84 | Professional | 53 · Discontinued | $3,311.31 | $3,311.31 | $4,466.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12,302.69 Median $12,302.69 Typical High $16,982.44 | Professional | 54 · Surgery only | $12,302.69 | $12,302.69 | $16,982.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,454.71 Median $2,454.71 Typical High $3,388.44 | Professional | 55 · Aftercare only | $2,454.71 | $2,454.71 | $3,388.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,659.59 Median $1,659.59 Typical High $2,238.72 | Professional | 56 · Pre-op care only | $1,659.59 | $1,659.59 | $2,238.72 |
Where Ohio sits
The same service costs 5754.4 times more in Oklahoma than in Maine. 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· 27th of 51
$10,233
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.