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 $707.95 Median $3,019.95 Typical High $12,022.64 | Facility | None | $707.95 | $3,019.95 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $257.04 Typical High $2,344.23 | Professional | None | $125.89 | $257.04 | $2,344.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $707.95 | Professional | None | $354.81 | $446.68 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $954.99 Typical High $2,691.53 | Facility | None | $512.86 | $954.99 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $954.99 Typical High $2,691.53 | Facility | None | $501.19 | $954.99 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
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 $97.72 Median $257.04 Typical High $2,398.83 | Facility | None | $97.72 | $257.04 | $2,398.83 |
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 $63.10 Median $128.82 Typical High $131.83 | Professional | 52 · Reduced service | $63.10 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $51.29 Typical High $52.48 | Professional | 53 · Discontinued | $25.70 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $190.55 Typical High $199.53 | Professional | 54 · Surgery only | $95.50 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $38.02 Typical High $39.81 | Professional | 55 · Aftercare only | $19.05 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $25.70 Typical High $26.30 | Professional | 56 · Pre-op care only | $12.59 | $25.70 | $26.30 |
Where Ohio sits
The same service costs 16.6 times more in California than in Texas. 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· 5th of 51
$355
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.