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 $24.55 Median $24.55 Typical High $125.89 | Facility | None | $24.55 | $24.55 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $125.89 | Professional | None | $24.55 | $24.55 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $42.66 Typical High $63.10 | Professional | None | $33.88 | $42.66 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $31.62 Typical High $64.57 | Professional | None | $23.44 | $31.62 | $64.57 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $22.39 Median $31.62 Typical High $66.07 | Professional | None | $22.39 | $31.62 | $66.07 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $35.48 Typical High $53.70 | Professional | None | $25.12 | $35.48 | $53.70 |
SummaCare Setting Professional Modifier None Typical Low $20.89 Median $25.70 Typical High $30.20 | Professional | None | $20.89 | $25.70 | $30.20 |
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 $21.38 Median $32.36 Typical High $64.57 | Professional | None | $21.38 | $32.36 | $64.57 |
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 $12.30 Median $12.30 Typical High $63.10 | Professional | 52 · Reduced service | $12.30 | $12.30 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $25.12 | Professional | 53 · Discontinued | $4.90 | $4.90 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $18.62 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $12.59 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $12.59 |
Where Ohio sits
The same service costs 2.5 times more in Minnesota than in Arkansas. 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· 20th of 51
$38.02
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.