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 $104.71 Median $190.55 Typical High $354.81 | Facility | None | $104.71 | $190.55 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $104.71 Typical High $120.23 | Professional | None | $63.10 | $104.71 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $120.23 Typical High $154.88 | Professional | None | $61.66 | $120.23 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $85.11 Typical High $173.78 | Professional | None | $50.12 | $85.11 | $173.78 |
Aultcare Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $114.82 Typical High $154.88 | Professional | None | $112.20 | $114.82 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $66.07 Typical High $104.71 | Professional | None | $50.12 | $66.07 | $104.71 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $102.33 | Professional | None | $67.61 | $74.13 | $102.33 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $147.91 | Professional | None | $63.10 | $95.50 | $147.91 |
SummaCare Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $138.04 | Professional | None | $64.57 | $91.20 | $138.04 |
United Setting Facility Modifier None Typical Low $275.42 Median $316.23 Typical High $457.09 | Facility | None | $275.42 | $316.23 | $457.09 |
United Setting Professional Modifier None Typical Low $44.67 Median $69.18 Typical High $109.65 | Professional | None | $44.67 | $69.18 | $109.65 |
3 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 $31.62 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $31.62 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $9.55 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.31 | $10.47 | $10.47 |
Where Ohio sits
The same service costs 4.3 times more in Alaska than in North Carolina. 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· 45th of 51
$77.62
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.