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 $1,258.93 Median $2,344.23 Typical High $4,265.80 | Facility | None | $1,258.93 | $2,344.23 | $4,265.80 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $4,265.80 | Professional | None | $1,258.93 | $1,513.56 | $4,265.80 |
Ambetter Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $2,951.21 Typical High $8,317.64 | Facility | None | $1,380.38 | $2,951.21 | $8,317.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $1,949.84 | Professional | None | $812.83 | $1,258.93 | $1,949.84 |
Aultcare Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,715.35 | Facility | None | $2,818.38 | $2,818.38 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,288.25 | $1,288.25 | $1,513.56 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $3,715.35 | Facility | None | $1,288.25 | $2,818.38 | $3,715.35 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,288.25 | $1,288.25 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $1,737.80 Median $2,454.71 Typical High $2,754.23 | Professional | None | $1,737.80 | $2,454.71 | $2,754.23 |
SummaCare Setting Professional Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $2,691.53 | Professional | None | $1,412.54 | $1,479.11 | $2,691.53 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,258.93 | $1,905.46 |
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 $630.96 Median $630.96 Typical High $1,445.44 | Professional | 52 · Reduced service | $630.96 | $630.96 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $575.44 | Professional | 53 · Discontinued | $257.04 | $257.04 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $2,187.76 | Professional | 54 · Surgery only | $954.99 | $954.99 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $436.52 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $288.40 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $288.40 |
Where Ohio sits
The same service costs 2.9 times more in Minnesota 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· 12th of 51
$1,318
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.