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 $54.95 Median $67.61 Typical High $67.61 | Facility | None | $54.95 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $67.61 Typical High $67.61 | Professional | None | $57.54 | $67.61 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.03 Typical High $0.07 | Facility | None | $0.02 | $0.03 | $0.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $67.61 Typical High $91.20 | Professional | None | $57.54 | $67.61 | $91.20 |
CareSource Setting Facility Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Facility | None | $15.49 | $15.49 | $15.49 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Facility | None | $158.49 | $158.49 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $79.43 | Professional | None | $74.13 | $74.13 | $79.43 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Facility | None | $158.49 | $158.49 | $213.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $79.43 | Professional | None | $74.13 | $74.13 | $79.43 |
United Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $93.33 | Professional | None | $66.07 | $79.43 | $93.33 |
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 $28.18 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $28.18 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $11.48 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $8.51 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.75 | $6.76 | $6.76 |
Where Ohio sits
The same service costs 6.5 times more in Arizona than in Hawaii. 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· 39th of 51
$67.61
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.