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 $4,677.35 Median $4,677.35 Typical High $12,302.69 | Facility | None | $4,677.35 | $4,677.35 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $5,011.87 | Professional | None | $4,677.35 | $4,677.35 | $5,011.87 |
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 $5,128.61 Median $5,128.61 Typical High $7,413.10 | Professional | None | $5,128.61 | $5,128.61 | $7,413.10 |
Cigna Setting Facility Modifier None Typical Low $10,715.19 Median $10,715.19 Typical High $14,454.40 | Facility | None | $10,715.19 | $10,715.19 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $10,715.19 Median $10,715.19 Typical High $14,454.40 | Facility | None | $10,715.19 | $10,715.19 | $14,454.40 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
Molina Setting Professional Modifier None Typical Low $5,128.61 Median $5,623.41 Typical High $6,760.83 | Professional | None | $5,128.61 | $5,623.41 | $6,760.83 |
SummaCare Setting Professional Modifier None Typical Low $70.79 Median $1,905.46 Typical High $9,332.54 | Professional | None | $70.79 | $1,905.46 | $9,332.54 |
United Setting Professional Modifier None Typical Low $4,466.84 Median $5,011.87 Typical High $5,495.41 | Professional | None | $4,466.84 | $5,011.87 | $5,495.41 |
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 $2,344.23 Median $2,344.23 Typical High $2,511.89 | Professional | 52 · Reduced service | $2,344.23 | $2,344.23 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $933.25 Typical High $1,000.00 | Professional | 53 · Discontinued | $933.25 | $933.25 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $707.95 Median $707.95 Typical High $741.31 | Professional | 55 · Aftercare only | $707.95 | $707.95 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $467.74 Median $467.74 Typical High $501.19 | Professional | 56 · Pre-op care only | $467.74 | $467.74 | $501.19 |
Where Ohio sits
The same service costs 1.8 times more in Alaska 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· 30th of 51
$5,012
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.