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 $17.38 Median $66.07 Typical High $100.00 | Facility | None | $17.38 | $66.07 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $66.07 Typical High $66.07 | Professional | None | $17.38 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.71 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $8.71 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $3.47 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $2.63 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $1.74 | $6.61 | $6.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.38 Median $40.74 Typical High $50.12 | Professional | None | $21.38 | $40.74 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $54.95 Typical High $63.10 | Professional | None | $14.79 | $54.95 | $63.10 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $14.79 Median $56.23 Typical High $63.10 | Professional | None | $14.79 | $56.23 | $63.10 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $63.10 Typical High $100.00 | Professional | None | $50.12 | $63.10 | $100.00 |
SummaCare Setting Professional Modifier None Typical Low $16.60 Median $21.38 Typical High $77.62 | Professional | None | $16.60 | $21.38 | $77.62 |
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 $15.49 Median $30.20 Typical High $66.07 | Professional | None | $15.49 | $30.20 | $66.07 |
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 4.4 times more in Hawaii than in Washington, DC. 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· 43rd of 51
$40.74
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.