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 $12.59 Median $25.70 Typical High $12,022.64 | Facility | None | $12.59 | $25.70 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $6.76 Median $12.88 Typical High $38.90 | Professional | None | $6.76 | $12.88 | $38.90 |
Ambetter Setting Professional Modifier None Typical Low $14.13 Median $16.22 Typical High $16.22 | Professional | None | $14.13 | $16.22 | $16.22 |
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 $7.94 Median $14.79 Typical High $27.54 | Professional | None | $7.94 | $14.79 | $27.54 |
CareSource Setting Facility Modifier None Typical Low $9.12 Median $537.03 Typical High $812.83 | Facility | None | $9.12 | $537.03 | $812.83 |
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 $6.46 Median $11.75 Typical High $27.54 | Professional | None | $6.46 | $11.75 | $27.54 |
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 $6.46 Median $11.75 Typical High $27.54 | Professional | None | $6.46 | $11.75 | $27.54 |
SummaCare Setting Professional Modifier None Typical Low $6.92 Median $11.48 Typical High $15.14 | Professional | None | $6.92 | $11.48 | $15.14 |
United Setting Facility Modifier None Typical Low $97.72 Median $251.19 Typical High $2,398.83 | Facility | None | $97.72 | $251.19 | $2,398.83 |
United Setting Professional Modifier None Typical Low $7.24 Median $12.59 Typical High $23.99 | Professional | None | $7.24 | $12.59 | $23.99 |
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 $3.39 Median $6.46 Typical High $6.46 | Professional | 52 · Reduced service | $3.39 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.35 Median $2.51 Typical High $2.51 | Professional | 53 · Discontinued | $1.35 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.13 Median $9.55 Typical High $9.55 | Professional | 54 · Surgery only | $5.13 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.02 Median $1.91 Typical High $1.91 | Professional | 55 · Aftercare only | $1.02 | $1.91 | $1.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $1.29 Typical High $1.29 | Professional | 56 · Pre-op care only | $0.68 | $1.29 | $1.29 |
Where Ohio sits
The same service costs 3.5 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· 26th of 51
$14.79
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.