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 $234.42 Median $10,232.93 Typical High $13,803.84 | Facility | None | $234.42 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $602.56 | Professional | None | $173.78 | $173.78 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $223.87 Typical High $354.81 | Professional | None | $218.78 | $223.87 | $354.81 |
CareSource Setting Professional Modifier None Typical Low $208.93 Median $218.78 Typical High $234.42 | Professional | None | $208.93 | $218.78 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $346.74 | Professional | None | $288.40 | $346.74 | $346.74 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
SummaCare Setting Facility Modifier None Typical Low $181.97 Median $190.55 Typical High $213.80 | Facility | None | $181.97 | $190.55 | $213.80 |
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 $85.11 Median $85.11 Typical High $239.88 | Professional | 52 · Reduced service | $85.11 | $85.11 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $95.50 | Professional | 53 · Discontinued | $34.67 | $34.67 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $354.81 | Professional | 54 · Surgery only | $128.82 | $128.82 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $70.79 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $47.86 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $47.86 |
Where Ohio sits
The same service costs 7.6 times more in Nebraska than in West Virginia. 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· 29th of 51
$224
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.