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 $39.81 Median $134.90 Typical High $10,715.19 | Facility | None | $39.81 | $134.90 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $39.81 Typical High $134.90 | Professional | None | $21.38 | $39.81 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $21.38 Median $40.74 Typical High $51.29 | Professional | None | $21.38 | $40.74 | $51.29 |
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 $22.91 Median $30.90 Typical High $53.70 | Professional | None | $22.91 | $30.90 | $53.70 |
CareSource Setting Facility Modifier None Typical Low $29.51 Median $537.03 Typical High $812.83 | Facility | None | $29.51 | $537.03 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $56.23 | Professional | None | $45.71 | $45.71 | $56.23 |
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 $21.38 Median $38.02 Typical High $74.13 | Professional | None | $21.38 | $38.02 | $74.13 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $524.81 | Facility | None | $50.12 | $75.86 | $524.81 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $20.42 Median $37.15 Typical High $74.13 | Professional | None | $20.42 | $37.15 | $74.13 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $107.15 | Professional | None | $56.23 | $75.86 | $107.15 |
SummaCare Setting Professional Modifier None Typical Low $22.39 Median $36.31 Typical High $56.23 | Professional | None | $22.39 | $36.31 | $56.23 |
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 $22.39 Median $37.15 Typical High $70.79 | Professional | None | $22.39 | $37.15 | $70.79 |
6 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 $10.72 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $10.72 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $4.37 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $30.20 Typical High $30.20 | Professional | 54 · Surgery only | $16.22 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $3.24 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $2.14 | $3.98 | $3.98 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $29.51 Median $32.36 Typical High $32.36 | Professional | 59 · Distinct service | $29.51 | $32.36 | $32.36 |
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· 45th of 51
$39.81
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.