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 $147.91 Median $380.19 Typical High $12,589.25 | Facility | None | $147.91 | $380.19 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $117.49 Typical High $302.00 | Professional | None | $53.70 | $117.49 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $173.78 | Professional | None | $104.71 | $138.04 | $173.78 |
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 $56.23 Median $83.18 Typical High $144.54 | Professional | None | $56.23 | $83.18 | $144.54 |
Aultcare Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $251.19 | Professional | None | $102.33 | $154.88 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $112.20 | Facility | None | $75.86 | $87.10 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $97.72 Typical High $173.78 | Facility | None | $58.88 | $97.72 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $114.82 Typical High $194.98 | Professional | None | $54.95 | $114.82 | $194.98 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $97.72 Typical High $169.82 | Facility | None | $58.88 | $97.72 | $169.82 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $54.95 Median $114.82 Typical High $194.98 | Professional | None | $54.95 | $114.82 | $194.98 |
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 Facility Modifier None Typical Low $46.77 Median $48.98 Typical High $54.95 | Facility | None | $46.77 | $48.98 | $54.95 |
SummaCare Setting Professional Modifier None Typical Low $52.48 Median $117.49 Typical High $154.88 | Professional | None | $52.48 | $117.49 | $154.88 |
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 $54.95 Median $104.71 Typical High $218.78 | Professional | None | $54.95 | $104.71 | $218.78 |
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 $26.92 Median $58.88 Typical High $61.66 | Professional | 52 · Reduced service | $26.92 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $23.44 Typical High $24.55 | Professional | 53 · Discontinued | $10.72 | $23.44 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $87.10 Typical High $91.20 | Professional | 54 · Surgery only | $40.74 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $17.38 Typical High $18.20 | Professional | 55 · Aftercare only | $8.13 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $11.75 Typical High $12.30 | Professional | 56 · Pre-op care only | $5.37 | $11.75 | $12.30 |
Where Ohio sits
The same service costs 3.1 times more in Wisconsin 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
$107
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.