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 $57.54 Median $251.19 Typical High $10,715.19 | Facility | None | $57.54 | $251.19 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $74.13 Typical High $251.19 | Professional | None | $30.20 | $74.13 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $51.29 Median $69.18 Typical High $102.33 | Professional | None | $51.29 | $69.18 | $102.33 |
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 $35.48 Median $74.13 Typical High $120.23 | Professional | None | $35.48 | $74.13 | $120.23 |
CareSource Setting Facility Modifier None Typical Low $36.31 Median $50.12 Typical High $64.57 | Facility | None | $36.31 | $50.12 | $64.57 |
CareSource Setting Professional Modifier None Typical Low $83.18 Median $87.10 Typical High $93.33 | Professional | None | $83.18 | $87.10 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $63.10 Typical High $120.23 | Facility | None | $52.48 | $63.10 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $69.18 Typical High $154.88 | Professional | None | $30.20 | $69.18 | $154.88 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $52.48 Median $66.07 Typical High $478.63 | Facility | None | $52.48 | $66.07 | $478.63 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $30.20 Median $69.18 Typical High $165.96 | Professional | None | $30.20 | $69.18 | $165.96 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $165.96 | Professional | None | $91.20 | $120.23 | $165.96 |
SummaCare Setting Facility Modifier None Typical Low $28.84 Median $30.20 Typical High $34.67 | Facility | None | $28.84 | $30.20 | $34.67 |
SummaCare Setting Professional Modifier None Typical Low $26.92 Median $77.62 Typical High $100.00 | Professional | None | $26.92 | $77.62 | $100.00 |
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 $32.36 Median $72.44 Typical High $134.90 | Professional | None | $32.36 | $72.44 | $134.90 |
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 $15.14 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $15.14 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $6.03 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $54.95 Typical High $54.95 | Professional | 54 · Surgery only | $22.39 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $4.47 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $3.02 | $7.41 | $7.41 |
Where Ohio sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 24th of 51
$87.10
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.