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 $89.13 Median $89.13 Typical High $354.81 | Facility | None | $89.13 | $89.13 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $354.81 | Professional | None | $79.43 | $89.13 | $354.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $87.10 Typical High $144.54 | Professional | None | $85.11 | $87.10 | $144.54 |
CareSource Setting Professional Modifier None Typical Low $120.23 Median $1,548.82 Typical High $2,754.23 | Professional | None | $120.23 | $1,548.82 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $70.79 | Professional | None | $50.12 | $50.12 | $70.79 |
United Setting Facility Modifier None Typical Low $707.95 Median $812.83 Typical High $1,174.90 | Facility | None | $707.95 | $812.83 | $1,174.90 |
United Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $165.96 | Professional | None | $61.66 | $89.13 | $165.96 |
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 $39.81 Median $43.65 Typical High $173.78 | Professional | 52 · Reduced service | $39.81 | $43.65 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $17.78 Typical High $70.79 | Professional | 53 · Discontinued | $15.85 | $17.78 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.18 Typical High $52.48 | Professional | 55 · Aftercare only | $11.75 | $13.18 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.91 Typical High $35.48 | Professional | 56 · Pre-op care only | $7.94 | $8.91 | $35.48 |
Where Ohio sits
The same service costs 5.0 times more in Alaska than in Pennsylvania. 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· 35th of 51
$89.13
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.