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 $21.88 Median $69.18 Typical High $204.17 | Facility | None | $21.88 | $69.18 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $58.88 Typical High $69.18 | Professional | None | $17.78 | $58.88 | $69.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.85 Median $44.67 Typical High $74.13 | Professional | None | $15.85 | $44.67 | $74.13 |
CareSource Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $112.20 | Professional | None | $67.61 | $72.44 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $54.95 Typical High $95.50 | Professional | None | $17.38 | $54.95 | $95.50 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $89.13 Median $144.54 Typical High $194.98 | Facility | None | $89.13 | $144.54 | $194.98 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $17.38 Median $54.95 Typical High $93.33 | Professional | None | $17.38 | $54.95 | $93.33 |
Molina Setting Professional Modifier None Typical Low $45.71 Median $61.66 Typical High $100.00 | Professional | None | $45.71 | $61.66 | $100.00 |
SummaCare Setting Professional Modifier None Typical Low $16.98 Median $20.89 Typical High $100.00 | Professional | None | $16.98 | $20.89 | $100.00 |
United Setting Facility Modifier None Typical Low $120.23 Median $141.25 Typical High $199.53 | Facility | None | $120.23 | $141.25 | $199.53 |
United Setting Professional Modifier None Typical Low $16.60 Median $47.86 Typical High $77.62 | Professional | None | $16.60 | $47.86 | $77.62 |
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 $8.91 Median $29.51 Typical High $34.67 | Professional | 52 · Reduced service | $8.91 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $11.75 Typical High $13.80 | Professional | 53 · Discontinued | $3.55 | $11.75 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $8.91 Typical High $10.23 | Professional | 55 · Aftercare only | $2.69 | $8.91 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $5.89 Typical High $6.92 | Professional | 56 · Pre-op care only | $1.78 | $5.89 | $6.92 |
Where Ohio sits
The same service costs 4.9 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· 37th of 51
$52.48
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.