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 $67,608.30 Median $74,131.02 Typical High $134,896.29 | Facility | None | $67,608.30 | $74,131.02 | $134,896.29 |
Aetna Setting Professional Modifier None Typical Low $67,608.30 Median $74,131.02 Typical High $74,131.02 | Professional | None | $67,608.30 | $74,131.02 | $74,131.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $75,857.76 Median $169,824.37 Typical High $501,187.23 | Facility | None | $75,857.76 | $169,824.37 | $501,187.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $31,622.78 Median $31,622.78 Typical High $93,325.43 | Professional | None | $31,622.78 | $31,622.78 | $93,325.43 |
Cigna Setting Facility Modifier None Typical Low $165,958.69 Median $165,958.69 Typical High $223,872.11 | Facility | None | $165,958.69 | $165,958.69 | $223,872.11 |
Cigna Setting Professional Modifier None Typical Low $77,624.71 Median $77,624.71 Typical High $91,201.08 | Professional | None | $77,624.71 | $77,624.71 | $91,201.08 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $165,958.69 Median $165,958.69 Typical High $223,872.11 | Facility | None | $165,958.69 | $165,958.69 | $223,872.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $77,624.71 Median $77,624.71 Typical High $91,201.08 | Professional | None | $77,624.71 | $77,624.71 | $91,201.08 |
Molina Setting Professional Modifier None Typical Low $70,794.58 Median $81,283.05 Typical High $93,325.43 | Professional | None | $70,794.58 | $81,283.05 | $93,325.43 |
SummaCare Setting Professional Modifier None Typical Low $81,283.05 Median $89,125.09 Typical High $162,181.01 | Professional | None | $81,283.05 | $89,125.09 | $162,181.01 |
United Setting Professional Modifier None Typical Low $75,857.76 Median $75,857.76 Typical High $102,329.30 | Professional | None | $75,857.76 | $75,857.76 | $102,329.30 |
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 $33,884.42 Median $36,307.81 Typical High $36,307.81 | Professional | 52 · Reduced service | $33,884.42 | $36,307.81 | $36,307.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13,489.63 Median $14,791.08 Typical High $14,791.08 | Professional | 53 · Discontinued | $13,489.63 | $14,791.08 | $14,791.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10,000.00 Median $10,964.78 Typical High $10,964.78 | Professional | 55 · Aftercare only | $10,000.00 | $10,964.78 | $10,964.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6,760.83 Median $7,413.10 Typical High $7,413.10 | Professional | 56 · Pre-op care only | $6,760.83 | $7,413.10 | $7,413.10 |
Where Ohio sits
The same service costs 3.4 times more in Alaska than in Nebraska. 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· 45th of 51
$74,131
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.