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 $42.66 Median $85.11 Typical High $275.42 | Facility | None | $42.66 | $85.11 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $85.11 Typical High $87.10 | Professional | None | $42.66 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $21.38 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $8.71 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $6.46 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.37 | $8.51 | $8.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $66.07 Typical High $77.62 | Professional | None | $50.12 | $66.07 | $77.62 |
CareSource Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $75.86 Typical High $85.11 | Professional | None | $35.48 | $75.86 | $85.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $35.48 Median $75.86 Typical High $85.11 | Professional | None | $35.48 | $75.86 | $85.11 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $95.50 Typical High $147.91 | Professional | None | $43.65 | $95.50 | $147.91 |
SummaCare Setting Professional Modifier None Typical Low $39.81 Median $51.29 Typical High $97.72 | Professional | None | $39.81 | $51.29 | $97.72 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,513.56 | Facility | None | $912.01 | $1,071.52 | $1,513.56 |
United Setting Professional Modifier None Typical Low $32.36 Median $51.29 Typical High $89.13 | Professional | None | $32.36 | $51.29 | $89.13 |
1 more rate 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Ohio sits
The same service costs 2.8 times more in Alaska than in Maryland. 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
$66.07
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.