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 $67.61 Median $125.89 Typical High $229.09 | Facility | None | $67.61 | $125.89 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $67.61 Typical High $190.55 | Professional | None | $39.81 | $67.61 | $190.55 |
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 $39.81 Median $60.26 Typical High $100.00 | Professional | None | $39.81 | $60.26 | $100.00 |
CareSource Setting Facility Modifier None Typical Low $56.23 Median $537.03 Typical High $812.83 | Facility | None | $56.23 | $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 $38.90 Median $61.66 Typical High $125.89 | Professional | None | $38.90 | $61.66 | $125.89 |
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 $38.90 Median $61.66 Typical High $125.89 | Professional | None | $38.90 | $61.66 | $125.89 |
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 $43.65 Median $72.44 Typical High $104.71 | Professional | None | $43.65 | $72.44 | $104.71 |
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 $38.90 Median $63.10 Typical High $114.82 | Professional | None | $38.90 | $63.10 | $114.82 |
4 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 $19.95 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $19.95 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $7.94 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $6.03 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $3.98 | $6.92 | $6.92 |
Where Ohio sits
The same service costs 3.3 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· 41st 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.