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 $19.50 Median $44.67 Typical High $100.00 | Facility | None | $19.50 | $44.67 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $29.51 Typical High $81.28 | Professional | None | $16.22 | $29.51 | $81.28 |
Ambetter Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
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 $14.79 Median $21.88 Typical High $42.66 | Professional | None | $14.79 | $21.88 | $42.66 |
CareSource Setting Facility Modifier None Typical Low $15.85 Median $416.87 Typical High $812.83 | Facility | None | $15.85 | $416.87 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $30.20 Median $31.62 Typical High $33.88 | Professional | None | $30.20 | $31.62 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $707.95 | Facility | None | $50.12 | $66.07 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $29.51 Typical High $52.48 | Professional | None | $15.85 | $29.51 | $52.48 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $524.81 | Facility | None | $50.12 | $66.07 | $524.81 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $15.85 Median $29.51 Typical High $52.48 | Professional | None | $15.85 | $29.51 | $52.48 |
Molina Setting Professional Modifier None Typical Low $7.41 Median $14.13 Typical High $24.55 | Professional | None | $7.41 | $14.13 | $24.55 |
SummaCare Setting Professional Modifier None Typical Low $12.30 Median $17.78 Typical High $35.48 | Professional | None | $12.30 | $17.78 | $35.48 |
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 $16.22 Median $29.51 Typical High $56.23 | Professional | None | $16.22 | $29.51 | $56.23 |
5 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 $8.13 Median $14.79 Typical High $36.31 | Professional | 52 · Reduced service | $8.13 | $14.79 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $5.89 Typical High $14.45 | Professional | 53 · Discontinued | $3.31 | $5.89 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.30 Median $22.39 Typical High $53.70 | Professional | 54 · Surgery only | $12.30 | $22.39 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $4.47 Typical High $10.72 | Professional | 55 · Aftercare only | $2.45 | $4.47 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $2.95 Typical High $7.24 | Professional | 56 · Pre-op care only | $1.62 | $2.95 | $7.24 |
Where Ohio sits
The same service costs 3.5 times more in Wisconsin 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· 45th of 51
$29.51
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.