How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $1,778.28 Median $1,778.28 Typical High $3,981.07 | Facility | None | $1,778.28 | $1,778.28 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,778.28 | $1,778.28 | $1,862.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.70 Median $2.34 Typical High $4.27 | Professional | None | $1.70 | $2.34 | $4.27 |
Cigna Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $5,370.32 | Facility | None | $3,981.07 | $3,981.07 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,862.09 | $1,862.09 | $2,187.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $5,370.32 | Facility | None | $3,981.07 | $3,981.07 | $5,370.32 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,862.09 | $1,862.09 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $2,187.76 Typical High $2,570.40 | Professional | None | $2,041.74 | $2,187.76 | $2,570.40 |
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 $870.96 Median $870.96 Typical High $933.25 | Professional | 52 · Reduced service | $870.96 | $870.96 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $371.54 | Professional | 53 · Discontinued | $354.81 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $281.84 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $186.21 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $186.21 |
Where Ohio sits
The same service costs 537.0 times more in Alaska than in Ohio. 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· 51st of 51
$5.50
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.