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 $74.13 Median $102.33 Typical High $288.40 | Facility | None | $74.13 | $102.33 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $104.71 | Professional | None | $74.13 | $102.33 | $104.71 |
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 $58.88 Median $70.79 Typical High $114.82 | Professional | None | $58.88 | $70.79 | $114.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $85.11 Median $107.15 Typical High $162.18 | Professional | 50 · Both sides | $85.11 | $107.15 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $56.23 Median $72.44 Typical High $95.50 | Facility | None | $56.23 | $72.44 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $75.86 Typical High $147.91 | Facility | None | $58.88 | $75.86 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $173.78 | Professional | None | $79.43 | $107.15 | $173.78 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $75.86 Typical High $147.91 | Facility | None | $58.88 | $75.86 | $147.91 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $173.78 | Professional | None | $79.43 | $107.15 | $173.78 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $158.49 | Professional | None | $79.43 | $104.71 | $158.49 |
SummaCare Setting Facility Modifier None Typical Low $35.48 Median $37.15 Typical High $42.66 | Facility | None | $35.48 | $37.15 | $42.66 |
SummaCare Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $138.04 | Professional | None | $69.18 | $95.50 | $138.04 |
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 $57.54 Median $91.20 Typical High $162.18 | Professional | None | $57.54 | $91.20 | $162.18 |
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 $37.15 Median $51.29 Typical High $52.48 | Professional | 52 · Reduced service | $37.15 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $20.42 Typical High $21.38 | Professional | 53 · Discontinued | $14.79 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $15.49 Typical High $15.85 | Professional | 55 · Aftercare only | $11.22 | $15.49 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.23 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.41 | $10.23 | $10.47 |
Where Ohio sits
The same service costs 3.8 times more in Alaska than in Florida. 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· 37th of 51
$100
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.