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 $5,011.87 Median $5,011.87 Typical High $7,244.36 | Facility | None | $5,011.87 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $7,244.36 | Professional | None | $5,011.87 | $5,011.87 | $7,244.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,623.41 Median $11,220.18 Typical High $15,848.93 | Facility | None | $5,623.41 | $11,220.18 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,951.21 Median $3,467.37 Typical High $7,244.36 | Professional | None | $2,951.21 | $3,467.37 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $11,481.54 Median $11,481.54 Typical High $15,488.17 | Facility | None | $11,481.54 | $11,481.54 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $6,309.57 | Professional | None | $5,370.32 | $5,370.32 | $6,309.57 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $11,481.54 Median $11,481.54 Typical High $15,488.17 | Facility | None | $11,481.54 | $11,481.54 | $15,488.17 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $6,309.57 | Professional | None | $5,370.32 | $5,370.32 | $6,309.57 |
Molina Setting Professional Modifier None Typical Low $5,248.07 Median $7,413.10 Typical High $7,943.28 | Professional | None | $5,248.07 | $7,413.10 | $7,943.28 |
SummaCare Setting Professional Modifier None Typical Low $5,623.41 Median $6,165.95 Typical High $10,964.78 | Professional | None | $5,623.41 | $6,165.95 | $10,964.78 |
United Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $7,762.47 | Professional | None | $5,248.07 | $5,248.07 | $7,762.47 |
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 $2,511.89 Median $2,511.89 Typical High $3,548.13 | Professional | 52 · Reduced service | $2,511.89 | $2,511.89 | $3,548.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,000.00 Median $1,000.00 Typical High $1,445.44 | Professional | 53 · Discontinued | $1,000.00 | $1,000.00 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $758.58 Median $758.58 Typical High $1,071.52 | Professional | 55 · Aftercare only | $758.58 | $758.58 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $501.19 Median $501.19 Typical High $724.44 | Professional | 56 · Pre-op care only | $501.19 | $501.19 | $724.44 |
Where Ohio sits
The same service costs 2.5 times more in Alaska than in Alabama. 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· 49th of 51
$5,012
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.