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 $117.49 Median $346.74 Typical High $12,022.64 | Facility | None | $117.49 | $346.74 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $181.97 Typical High $416.87 | Professional | None | $63.10 | $181.97 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $100.00 Typical High $223.87 | Professional | None | $61.66 | $100.00 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $128.82 | Facility | None | $95.50 | $95.50 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $177.83 Typical High $288.40 | Professional | None | $64.57 | $177.83 | $288.40 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $128.82 Median $446.68 Typical High $1,318.26 | Facility | None | $128.82 | $446.68 | $1,318.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $64.57 Median $177.83 Typical High $288.40 | Professional | None | $64.57 | $177.83 | $288.40 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $323.59 | Professional | None | $158.49 | $234.42 | $323.59 |
SummaCare Setting Professional Modifier None Typical Low $56.23 Median $194.98 Typical High $257.04 | Professional | None | $56.23 | $194.98 | $257.04 |
United Setting Facility Modifier None Typical Low $43.65 Median $48.98 Typical High $58.88 | Facility | None | $43.65 | $48.98 | $58.88 |
United Setting Professional Modifier None Typical Low $60.26 Median $138.04 Typical High $338.84 | Professional | None | $60.26 | $138.04 | $338.84 |
5 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 $91.20 Typical High $109.65 | Professional | 52 · Reduced service | $31.62 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $36.31 Typical High $43.65 | Professional | 53 · Discontinued | $12.88 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $138.04 Typical High $162.18 | Professional | 54 · Surgery only | $47.86 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $27.54 Typical High $32.36 | Professional | 55 · Aftercare only | $9.55 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $18.20 Typical High $21.88 | Professional | 56 · Pre-op care only | $6.31 | $18.20 | $21.88 |
Where Ohio sits
The same service costs 2.9 times more in Washington than in Kentucky. 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
$148
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.