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 $3,388.44 Median $3,388.44 Typical High $5,888.44 | Facility | None | $3,388.44 | $3,388.44 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $4,466.84 | Professional | None | $3,388.44 | $3,388.44 | $4,466.84 |
Ambetter Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $2,754.23 Typical High $7,413.10 | Facility | None | $1,584.89 | $2,754.23 | $7,413.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $3,630.78 | Professional | None | $933.25 | $933.25 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $10,232.93 | Facility | None | $7,762.47 | $7,762.47 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $10,232.93 | Facility | None | $7,762.47 | $7,762.47 | $10,232.93 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Professional Modifier None Typical Low $3,890.45 Median $4,265.80 Typical High $5,888.44 | Professional | None | $3,890.45 | $4,265.80 | $5,888.44 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
United Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,677.35 | Professional | None | $3,467.37 | $3,467.37 | $4,677.35 |
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 $1,698.24 Median $1,698.24 Typical High $2,238.72 | Professional | 52 · Reduced service | $1,698.24 | $1,698.24 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $676.08 Typical High $891.25 | Professional | 53 · Discontinued | $676.08 | $676.08 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $501.19 Typical High $676.08 | Professional | 55 · Aftercare only | $501.19 | $501.19 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $338.84 Typical High $446.68 | Professional | 56 · Pre-op care only | $338.84 | $338.84 | $446.68 |
Where Ohio sits
The same service costs 1.6 times more in North Carolina than in Nebraska. 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
$3,467
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.