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 $53.70 Median $229.09 Typical High $12,022.64 | Facility | None | $53.70 | $229.09 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $85.11 Typical High $229.09 | Professional | None | $29.51 | $85.11 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $44.67 Median $75.86 Typical High $107.15 | Professional | None | $44.67 | $75.86 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $50.12 Typical High $95.50 | Professional | None | $26.30 | $50.12 | $95.50 |
Aultcare Setting Professional Modifier None Typical Low $95.50 Median $107.15 Typical High $181.97 | Professional | None | $95.50 | $107.15 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $41.69 Median $537.03 Typical High $812.83 | Facility | None | $41.69 | $537.03 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $120.23 | Professional | None | $97.72 | $97.72 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $794.33 | Facility | None | $50.12 | $66.07 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $79.43 Typical High $128.82 | Professional | None | $28.84 | $79.43 | $128.82 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $630.96 | Facility | None | $50.12 | $66.07 | $630.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $30.20 Median $61.66 Typical High $117.49 | Professional | None | $30.20 | $61.66 | $117.49 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $158.49 | Professional | None | $85.11 | $112.20 | $158.49 |
SummaCare Setting Professional Modifier None Typical Low $28.84 Median $53.70 Typical High $117.49 | Professional | None | $28.84 | $53.70 | $117.49 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $28.18 Median $57.54 Typical High $151.36 | Professional | None | $28.18 | $57.54 | $151.36 |
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 $14.79 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $14.79 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $5.89 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $63.10 Typical High $63.10 | Professional | 54 · Surgery only | $21.88 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $4.37 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $2.95 | $8.51 | $8.51 |
Where Ohio sits
The same service costs 3.3 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· 42nd of 51
$67.61
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.