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 $512.86 Median $1,412.54 Typical High $1,737.80 | Facility | None | $512.86 | $1,412.54 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,174.90 | Professional | None | $512.86 | $512.86 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $812.83 Typical High $1,548.82 | Facility | None | $549.54 | $812.83 | $1,548.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $977.24 | Professional | None | $512.86 | $512.86 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
CareSource Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,698.24 | Facility | None | $977.24 | $1,122.02 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $588.84 | Professional | None | $512.86 | $512.86 | $588.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,479.11 | Facility | None | $954.99 | $1,122.02 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $588.84 | Professional | None | $512.86 | $512.86 | $588.84 |
Molina Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $741.31 | Professional | None | $562.34 | $645.65 | $741.31 |
SummaCare Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $1,023.29 | Professional | None | $512.86 | $562.34 | $1,023.29 |
United Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
United Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $758.58 | Professional | None | $512.86 | $512.86 | $758.58 |
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 $257.04 Median $257.04 Typical High $588.84 | Professional | 52 · Reduced service | $257.04 | $257.04 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $234.42 | Professional | 53 · Discontinued | $102.33 | $102.33 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $891.25 | Professional | 54 · Surgery only | $389.05 | $389.05 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $177.83 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $117.49 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $117.49 |
Where Ohio sits
The same service costs 1.6 times more in Arizona than in Wyoming. 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· 4th of 51
$631
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.