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 $117.49 Median $134.90 Typical High $288.40 | Facility | None | $117.49 | $134.90 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $269.15 | Professional | None | $117.49 | $117.49 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $138.04 | Professional | None | $63.10 | $100.00 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $234.42 | Professional | None | $107.15 | $131.83 | $234.42 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $128.82 Median $457.09 Typical High $741.31 | Facility | None | $128.82 | $457.09 | $741.31 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $234.42 | Professional | None | $107.15 | $131.83 | $234.42 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $204.17 | Professional | None | $107.15 | $134.90 | $204.17 |
SummaCare Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $144.54 | Professional | None | $100.00 | $123.03 | $144.54 |
United Setting Facility Modifier None Typical Low $97.72 Median $109.65 Typical High $134.90 | Facility | None | $97.72 | $109.65 | $134.90 |
United Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $245.47 | Professional | None | $104.71 | $131.83 | $245.47 |
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 $58.88 Median $58.88 Typical High $144.54 | Professional | 52 · Reduced service | $58.88 | $58.88 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $57.54 | Professional | 53 · Discontinued | $23.44 | $23.44 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $43.65 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $28.84 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $28.84 |
Where Ohio sits
The same service costs 2.8 times more in Alaska than in Indiana. 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· 48th of 51
$115
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.