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 $478.63 Median $478.63 Typical High $2,630.27 | Facility | None | $478.63 | $478.63 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $524.81 | Professional | None | $478.63 | $478.63 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $426.58 Median $691.83 Typical High $1,318.26 | Facility | None | $426.58 | $691.83 | $1,318.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $660.69 | Professional | None | $478.63 | $478.63 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
CareSource Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $575.44 | Professional | None | $426.58 | $426.58 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,548.82 | Facility | None | $891.25 | $1,023.29 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $575.44 | Professional | None | $478.63 | $478.63 | $575.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,348.96 | Facility | None | $758.58 | $1,023.29 | $1,348.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $602.56 | Professional | None | $478.63 | $478.63 | $602.56 |
Molina Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $575.44 | Professional | None | $380.19 | $436.52 | $575.44 |
SummaCare Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $588.84 | Professional | None | $478.63 | $501.19 | $588.84 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
United Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $446.68 | Professional | None | $363.08 | $416.87 | $446.68 |
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 $234.42 Median $234.42 Typical High $263.03 | Professional | 52 · Reduced service | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $104.71 | Professional | 53 · Discontinued | $95.50 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $389.05 | Professional | 54 · Surgery only | $354.81 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $77.62 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $52.48 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $52.48 |
Where Ohio sits
The same service costs 1.8 times more in Wyoming than in North Carolina. 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· 38th of 51
$479
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.