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 $1,202.26 Median $1,202.26 Typical High $3,715.35 | Facility | None | $1,202.26 | $1,202.26 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,288.25 | Professional | None | $1,202.26 | $1,202.26 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $537.03 | Professional | None | $245.47 | $288.40 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,630.78 | Facility | None | $2,754.23 | $2,754.23 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,630.78 | Facility | None | $2,754.23 | $2,754.23 | $3,630.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $478.63 | Professional | None | $288.40 | $323.59 | $478.63 |
SummaCare Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,380.38 | $1,698.24 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,148.15 | $1,258.93 | $1,479.11 |
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 $602.56 Median $602.56 Typical High $645.65 | Professional | 52 · Reduced service | $602.56 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $257.04 | Professional | 53 · Discontinued | $239.88 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $194.98 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $128.82 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $128.82 |
Where Ohio sits
The same service costs 6.9 times more in Alaska than in Kentucky. 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· 44th of 51
$1,202
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.