How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $478.63 Median $478.63 Typical High $1,778.28 | Facility | None | $478.63 | $478.63 | $1,778.28 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $1,318.26 | Professional | None | $478.63 | $478.63 | $1,318.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $691.83 | Professional | None | $354.81 | $416.87 | $691.83 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $588.84 | Professional | None | $524.81 | $524.81 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $758.58 | Professional | None | $426.58 | $426.58 | $758.58 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $741.31 | Professional | None | $426.58 | $426.58 | $741.31 |
Molina Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $851.14 | Professional | None | $446.68 | $549.54 | $851.14 |
SummaCare Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $616.60 | Professional | None | $524.81 | $524.81 | $616.60 |
United Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $724.44 | Professional | None | $346.74 | $416.87 | $724.44 |
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 $239.88 Median $239.88 Typical High $275.42 | Professional | 52 · Reduced service | $239.88 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $109.65 | Professional | 53 · Discontinued | $95.50 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $54.95 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $54.95 |
Where Ohio sits
The same service costs 3.2 times more in Alaska than in New York. 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
$479
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.