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 $57.54 Median $245.47 Typical High $10,232.93 | Facility | None | $57.54 | $245.47 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $72.44 Typical High $234.42 | Professional | None | $32.36 | $72.44 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $37.15 Median $70.79 Typical High $83.18 | Professional | None | $37.15 | $70.79 | $83.18 |
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 $30.90 Median $56.23 Typical High $102.33 | Professional | None | $30.90 | $56.23 | $102.33 |
CareSource Setting Facility Modifier None Typical Low $45.71 Median $537.03 Typical High $812.83 | Facility | None | $45.71 | $537.03 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $102.33 | Professional | None | $85.11 | $85.11 | $102.33 |
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 $30.90 Median $67.61 Typical High $123.03 | Professional | None | $30.90 | $67.61 | $123.03 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $794.33 | Facility | None | $50.12 | $100.00 | $794.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $30.90 Median $67.61 Typical High $123.03 | Professional | None | $30.90 | $67.61 | $123.03 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $74.13 Typical High $107.15 | Professional | None | $54.95 | $74.13 | $107.15 |
SummaCare Setting Professional Modifier None Typical Low $35.48 Median $70.79 Typical High $102.33 | Professional | None | $35.48 | $70.79 | $102.33 |
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 $30.20 Median $63.10 Typical High $128.82 | Professional | None | $30.20 | $63.10 | $128.82 |
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 $16.22 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $16.22 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $6.46 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $54.95 Typical High $54.95 | Professional | 54 · Surgery only | $24.55 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $4.90 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $3.24 | $7.24 | $7.24 |
Where Ohio sits
The same service costs 3.7 times more in Alaska 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
$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.