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 $3,890.45 Median $3,890.45 Typical High $6,760.83 | Facility | None | $3,890.45 | $3,890.45 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $4,073.80 | Professional | None | $3,890.45 | $3,890.45 | $4,073.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.03 Typical High $0.07 | Facility | None | $0.02 | $0.03 | $0.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $7,079.46 | Professional | None | $4,786.30 | $4,786.30 | $7,079.46 |
CareSource Setting Facility Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Facility | None | $6,918.31 | $6,918.31 | $6,918.31 |
CareSource Setting Professional Modifier None Typical Low $5,128.61 Median $6,918.31 Typical High $6,918.31 | Professional | None | $5,128.61 | $6,918.31 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $4,786.30 Median $10,471.29 Typical High $13,803.84 | Facility | None | $4,786.30 | $10,471.29 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,623.41 | Professional | None | $4,786.30 | $4,786.30 | $5,623.41 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $4,786.30 Median $10,471.29 Typical High $13,803.84 | Facility | None | $4,786.30 | $10,471.29 | $13,803.84 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,623.41 | Professional | None | $4,786.30 | $4,786.30 | $5,623.41 |
Molina Setting Professional Modifier None Typical Low $4,786.30 Median $5,248.07 Typical High $6,309.57 | Professional | None | $4,786.30 | $5,248.07 | $6,309.57 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $7,413.10 | Professional | None | $50.12 | $70.79 | $7,413.10 |
United Setting Professional Modifier None Typical Low $5,248.07 Median $5,623.41 Typical High $6,309.57 | Professional | None | $5,248.07 | $5,623.41 | $6,309.57 |
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 $1,949.84 Median $1,949.84 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,949.84 | $1,949.84 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $776.25 Typical High $812.83 | Professional | 53 · Discontinued | $776.25 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $575.44 Typical High $616.60 | Professional | 55 · Aftercare only | $575.44 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $389.05 Typical High $407.38 | Professional | 56 · Pre-op care only | $389.05 | $389.05 | $407.38 |
Where Ohio sits
The same service costs 1.5 times more in Alaska than in Idaho. 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· 36th of 51
$4,786
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.