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 $281.84 Median $281.84 Typical High $602.56 | Facility | None | $281.84 | $281.84 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $512.86 | Professional | None | $281.84 | $281.84 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $302.00 | Professional | None | $281.84 | $302.00 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $398.11 | Professional | None | $186.21 | $218.78 | $398.11 |
Aultcare Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $436.52 | Professional | None | $269.15 | $309.03 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $436.52 | Professional | None | $229.09 | $229.09 | $436.52 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $389.05 | Professional | None | $229.09 | $229.09 | $389.05 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $478.63 | Professional | None | $245.47 | $302.00 | $478.63 |
SummaCare Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $371.54 | Professional | None | $234.42 | $316.23 | $371.54 |
United Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $407.38 | Professional | None | $186.21 | $218.78 | $407.38 |
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 $141.25 Median $141.25 Typical High $162.18 | Professional | 52 · Reduced service | $141.25 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $64.57 | Professional | 53 · Discontinued | $56.23 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $48.98 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $32.36 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $32.36 |
Where Ohio sits
The same service costs 2.8 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
$269
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.