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 $77.62 Median $190.55 Typical High $12,022.64 | Facility | None | $77.62 | $190.55 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $102.33 Typical High $269.15 | Professional | None | $42.66 | $102.33 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $234.42 | Professional | None | $109.65 | $109.65 | $234.42 |
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 $44.67 Median $70.79 Typical High $123.03 | Professional | None | $44.67 | $70.79 | $123.03 |
Aultcare Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $138.04 | Professional | None | $131.83 | $131.83 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $58.88 Median $724.44 Typical High $1,096.48 | Facility | None | $58.88 | $724.44 | $1,096.48 |
CareSource Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $147.91 | Professional | None | $120.23 | $120.23 | $147.91 |
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 $42.66 Median $97.72 Typical High $162.18 | Professional | None | $42.66 | $97.72 | $162.18 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $794.33 | Facility | None | $50.12 | $66.07 | $794.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $43.65 Median $97.72 Typical High $165.96 | Professional | None | $43.65 | $97.72 | $165.96 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $213.80 | Professional | None | $112.20 | $151.36 | $213.80 |
SummaCare Setting Professional Modifier None Typical Low $42.66 Median $75.86 Typical High $151.36 | Professional | None | $42.66 | $75.86 | $151.36 |
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 $44.67 Median $83.18 Typical High $190.55 | Professional | None | $44.67 | $83.18 | $190.55 |
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 $21.38 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $21.38 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $8.51 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $77.62 Typical High $77.62 | Professional | 54 · Surgery only | $31.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $6.31 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $10.23 Typical High $10.47 | Professional | 56 · Pre-op care only | $4.27 | $10.23 | $10.47 |
Where Ohio sits
The same service costs 3.4 times more in Alaska than in New Jersey. 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
$95.50
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.