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 $30.90 Median $54.95 Typical High $295.12 | Facility | None | $30.90 | $54.95 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $43.65 Typical High $54.95 | Professional | None | $30.90 | $43.65 | $54.95 |
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 $27.54 Median $37.15 Typical High $56.23 | Professional | None | $27.54 | $37.15 | $56.23 |
CareSource Setting Facility Modifier None Typical Low $38.02 Median $537.03 Typical High $812.83 | Facility | None | $38.02 | $537.03 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $707.95 | Facility | None | $50.12 | $66.07 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $52.48 Typical High $85.11 | Professional | None | $33.11 | $52.48 | $85.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $707.95 | Facility | None | $50.12 | $66.07 | $707.95 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $33.11 Median $52.48 Typical High $83.18 | Professional | None | $33.11 | $52.48 | $83.18 |
Molina Setting Professional Modifier None Typical Low $52.48 Median $67.61 Typical High $104.71 | Professional | None | $52.48 | $67.61 | $104.71 |
SummaCare Setting Professional Modifier None Typical Low $27.54 Median $44.67 Typical High $64.57 | Professional | None | $27.54 | $44.67 | $64.57 |
United Setting Facility Modifier None Typical Low $89.13 Median $251.19 Typical High $2,398.83 | Facility | None | $89.13 | $251.19 | $2,398.83 |
United Setting Professional Modifier None Typical Low $25.12 Median $44.67 Typical High $81.28 | Professional | None | $25.12 | $44.67 | $81.28 |
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 $15.49 Median $26.92 Typical High $27.54 | Professional | 52 · Reduced service | $15.49 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $6.17 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $8.13 Typical High $8.32 | Professional | 55 · Aftercare only | $4.68 | $8.13 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.09 | $5.50 | $5.50 |
Where Ohio sits
The same service costs 3.6 times more in Alaska than in Virginia. 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· 33rd of 51
$52.48
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.