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 $87.10 Median $169.82 Typical High $12,022.64 | Facility | None | $87.10 | $169.82 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $70.79 Typical High $239.88 | Professional | None | $47.86 | $70.79 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $104.71 | Professional | None | $89.13 | $97.72 | $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 $51.29 Median $83.18 Typical High $147.91 | Professional | None | $51.29 | $83.18 | $147.91 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $77.62 Median $120.23 Typical High $204.17 | Professional | 50 · Both sides | $77.62 | $120.23 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $794.33 | Facility | None | $50.12 | $66.07 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $208.93 | Professional | None | $51.29 | $79.43 | $208.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $630.96 | Facility | None | $50.12 | $66.07 | $630.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $208.93 | Professional | None | $51.29 | $79.43 | $208.93 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $109.65 | Professional | None | $63.10 | $81.28 | $109.65 |
SummaCare Setting Professional Modifier None Typical Low $45.71 Median $77.62 Typical High $123.03 | Professional | None | $45.71 | $77.62 | $123.03 |
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 $52.48 Median $83.18 Typical High $162.18 | Professional | None | $52.48 | $83.18 | $162.18 |
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 $23.99 Median $35.48 Typical High $36.31 | Professional | 52 · Reduced service | $23.99 | $35.48 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $14.45 Typical High $14.79 | Professional | 53 · Discontinued | $9.55 | $14.45 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $53.70 Typical High $54.95 | Professional | 54 · Surgery only | $35.48 | $53.70 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.72 Typical High $10.96 | Professional | 55 · Aftercare only | $7.08 | $10.72 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.08 Typical High $7.41 | Professional | 56 · Pre-op care only | $4.79 | $7.08 | $7.41 |
Where Ohio sits
The same service costs 3.2 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· 41st of 51
$85.11
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.