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 $33.88 Median $52.48 Typical High $147.91 | Facility | None | $33.88 | $52.48 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $52.48 Typical High $138.04 | Professional | None | $33.88 | $52.48 | $138.04 |
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 $23.44 Median $29.51 Typical High $48.98 | Professional | None | $23.44 | $29.51 | $48.98 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $34.67 Median $43.65 Typical High $72.44 | Professional | 50 · Both sides | $34.67 | $43.65 | $72.44 |
CareSource Setting Facility Modifier None Typical Low $42.66 Median $537.03 Typical High $812.83 | Facility | None | $42.66 | $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 $34.67 Median $51.29 Typical High $87.10 | Professional | None | $34.67 | $51.29 | $87.10 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $794.33 | Facility | None | $50.12 | $66.07 | $794.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $34.67 Median $51.29 Typical High $87.10 | Professional | None | $34.67 | $51.29 | $87.10 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $104.71 | Professional | None | $53.70 | $69.18 | $104.71 |
SummaCare Setting Professional Modifier None Typical Low $31.62 Median $47.86 Typical High $69.18 | Professional | None | $31.62 | $47.86 | $69.18 |
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 $23.44 Median $40.74 Typical High $77.62 | Professional | None | $23.44 | $40.74 | $77.62 |
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 $16.60 Median $25.70 Typical High $26.30 | Professional | 52 · Reduced service | $16.60 | $25.70 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $10.23 Typical High $10.47 | Professional | 53 · Discontinued | $6.76 | $10.23 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $7.76 Typical High $7.94 | Professional | 55 · Aftercare only | $5.01 | $7.76 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $5.13 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.39 | $5.13 | $5.25 |
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· 36th of 51
$51.29
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.