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 $117.49 Median $281.84 Typical High $398.11 | Facility | None | $117.49 | $281.84 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $331.13 | Professional | None | $79.43 | $117.49 | $331.13 |
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 $63.10 Median $79.43 Typical High $120.23 | Professional | None | $63.10 | $79.43 | $120.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $95.50 Median $120.23 Typical High $181.97 | Professional | 50 · Both sides | $95.50 | $120.23 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $69.18 Median $89.13 Typical High $102.33 | Facility | None | $69.18 | $89.13 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $91.20 Typical High $169.82 | Facility | None | $58.88 | $91.20 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $199.53 | Professional | None | $85.11 | $120.23 | $199.53 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $91.20 Typical High $169.82 | Facility | None | $58.88 | $91.20 | $169.82 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $199.53 | Professional | None | $85.11 | $120.23 | $199.53 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $208.93 | Professional | None | $107.15 | $138.04 | $208.93 |
SummaCare Setting Facility Modifier None Typical Low $43.65 Median $45.71 Typical High $51.29 | Facility | None | $43.65 | $45.71 | $51.29 |
SummaCare Setting Professional Modifier None Typical Low $74.13 Median $109.65 Typical High $158.49 | Professional | None | $74.13 | $109.65 | $158.49 |
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 $61.66 Median $100.00 Typical High $181.97 | Professional | None | $61.66 | $100.00 | $181.97 |
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 $39.81 Median $58.88 Typical High $63.10 | Professional | 52 · Reduced service | $39.81 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $23.44 Typical High $25.12 | Professional | 53 · Discontinued | $15.85 | $23.44 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $17.78 Typical High $18.62 | Professional | 55 · Aftercare only | $12.02 | $17.78 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $11.75 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.94 | $11.75 | $12.59 |
Where Ohio sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 40th of 51
$117
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.