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 $117.49 Median $218.78 Typical High $549.54 | Facility | None | $117.49 | $218.78 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $549.54 | Professional | None | $117.49 | $117.49 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $104.71 | Professional | None | $100.00 | $100.00 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $169.82 | Professional | None | $93.33 | $109.65 | $169.82 |
Aultcare Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | None | $125.89 | $125.89 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $120.23 Typical High $190.55 | Professional | None | $114.82 | $120.23 | $190.55 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $114.82 Median $120.23 Typical High $194.98 | Professional | None | $114.82 | $120.23 | $194.98 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $158.49 | Professional | None | $83.18 | $104.71 | $158.49 |
SummaCare Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $128.82 | Professional | None | $109.65 | $109.65 | $128.82 |
United Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $199.53 | Professional | None | $95.50 | $112.20 | $199.53 |
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 $58.88 Median $58.88 Typical High $69.18 | Professional | 52 · Reduced service | $58.88 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $27.54 | Professional | 53 · Discontinued | $23.44 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $20.42 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $13.80 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $13.80 |
Where Ohio sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 44th of 51
$117
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.