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 $27.54 Median $41.69 Typical High $112.20 | Facility | None | $27.54 | $41.69 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $41.69 Typical High $43.65 | Professional | None | $27.54 | $41.69 | $43.65 |
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 $26.92 Median $31.62 Typical High $51.29 | Professional | None | $26.92 | $31.62 | $51.29 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $38.02 Median $47.86 Typical High $72.44 | Professional | 50 · Both sides | $38.02 | $47.86 | $72.44 |
CareSource Setting Facility Modifier None Typical Low $22.39 Median $28.84 Typical High $33.88 | Facility | None | $22.39 | $28.84 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $32.36 Typical High $100.00 | Facility | None | $22.39 | $32.36 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $42.66 Typical High $72.44 | Professional | None | $29.51 | $42.66 | $72.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $22.39 Median $32.36 Typical High $100.00 | Facility | None | $22.39 | $32.36 | $100.00 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $29.51 Median $42.66 Typical High $70.79 | Professional | None | $29.51 | $42.66 | $70.79 |
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 Facility Modifier None Typical Low $12.30 Median $12.88 Typical High $14.79 | Facility | None | $12.30 | $12.88 | $14.79 |
SummaCare Setting Professional Modifier None Typical Low $26.30 Median $35.48 Typical High $51.29 | Professional | None | $26.30 | $35.48 | $51.29 |
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 $22.39 Median $38.90 Typical High $67.61 | Professional | None | $22.39 | $38.90 | $67.61 |
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 $13.80 Median $20.89 Typical High $21.88 | Professional | 52 · Reduced service | $13.80 | $20.89 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $8.32 Typical High $8.71 | Professional | 53 · Discontinued | $5.50 | $8.32 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $6.31 Typical High $6.46 | Professional | 55 · Aftercare only | $4.07 | $6.31 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $4.17 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.75 | $4.17 | $4.37 |
Where Ohio sits
The same service costs 3.3 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· 36th of 51
$43.65
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.