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 $8,511.38 Median $8,511.38 Typical High $16,982.44 | Facility | None | $8,511.38 | $8,511.38 | $16,982.44 |
Aetna Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,912.51 | Professional | None | $8,511.38 | $8,511.38 | $8,912.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,549.93 Median $20,417.38 Typical High $57,543.99 | Facility | None | $9,549.93 | $20,417.38 | $57,543.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $6,606.93 | Professional | None | $426.58 | $426.58 | $6,606.93 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
CareSource Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,709.64 | $8,709.64 | $8,709.64 |
Cigna Setting Facility Modifier None Typical Low $8,709.64 Median $19,498.45 Typical High $25,703.96 | Facility | None | $8,709.64 | $19,498.45 | $25,703.96 |
Cigna Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $8,709.64 Median $19,498.45 Typical High $25,703.96 | Facility | None | $8,709.64 | $19,498.45 | $25,703.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
Molina Setting Professional Modifier None Typical Low $2,691.53 Median $3,019.95 Typical High $3,548.13 | Professional | None | $2,691.53 | $3,019.95 | $3,548.13 |
SummaCare Setting Professional Modifier None Typical Low $9,332.54 Median $9,772.37 Typical High $11,481.54 | Professional | None | $9,332.54 | $9,772.37 | $11,481.54 |
United Setting Professional Modifier None Typical Low $8,128.31 Median $8,912.51 Typical High $9,772.37 | Professional | None | $8,128.31 | $8,912.51 | $9,772.37 |
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 $4,265.80 Median $4,265.80 Typical High $4,466.84 | Professional | 52 · Reduced service | $4,265.80 | $4,265.80 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,698.24 Median $1,698.24 Typical High $1,778.28 | Professional | 53 · Discontinued | $1,698.24 | $1,698.24 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,258.93 Median $1,258.93 Typical High $1,348.96 | Professional | 55 · Aftercare only | $1,258.93 | $1,258.93 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $851.14 Median $851.14 Typical High $891.25 | Professional | 56 · Pre-op care only | $851.14 | $851.14 | $891.25 |
Where Ohio sits
The same service costs 26.3 times more in Alaska than in Montana. 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· 37th of 51
$8,710
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.