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 $15.14 Median $74.13 Typical High $234.42 | Facility | None | $15.14 | $74.13 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $74.13 Typical High $83.18 | Professional | None | $15.14 | $74.13 | $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 $12.30 Median $15.14 Typical High $22.91 | Professional | None | $12.30 | $15.14 | $22.91 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $18.20 Median $22.91 Typical High $34.67 | Professional | 50 · Both sides | $18.20 | $22.91 | $34.67 |
CareSource Setting Facility Modifier None Typical Low $19.50 Median $61.66 Typical High $81.28 | Facility | None | $19.50 | $61.66 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $77.62 Typical High $602.56 | Facility | None | $58.88 | $77.62 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $67.61 Typical High $109.65 | Professional | None | $16.60 | $67.61 | $109.65 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $75.86 Typical High $602.56 | Facility | None | $58.88 | $75.86 | $602.56 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $16.60 Median $67.61 Typical High $107.15 | Professional | None | $16.60 | $67.61 | $107.15 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $67.61 Typical High $102.33 | Professional | None | $51.29 | $67.61 | $102.33 |
SummaCare Setting Facility Modifier None Typical Low $32.36 Median $34.67 Typical High $38.90 | Facility | None | $32.36 | $34.67 | $38.90 |
SummaCare Setting Professional Modifier None Typical Low $13.80 Median $42.66 Typical High $85.11 | Professional | None | $13.80 | $42.66 | $85.11 |
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 $12.59 Median $51.29 Typical High $112.20 | Professional | None | $12.59 | $51.29 | $112.20 |
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 $7.59 Median $37.15 Typical High $38.90 | Professional | 52 · Reduced service | $7.59 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $14.79 Typical High $15.49 | Professional | 53 · Discontinued | $3.02 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $10.96 Typical High $11.75 | Professional | 55 · Aftercare only | $2.24 | $10.96 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $7.41 Typical High $7.76 | Professional | 56 · Pre-op care only | $1.51 | $7.41 | $7.76 |
Where Ohio sits
The same service costs 5.9 times more in Iowa 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· 39th of 51
$53.70
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.