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 $16.60 Median $16.60 Typical High $74.13 | Facility | None | $16.60 | $16.60 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $74.13 | Professional | None | $16.60 | $16.60 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $30.20 Typical High $47.86 | Professional | None | $25.70 | $30.20 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $26.92 Typical High $50.12 | Professional | None | $15.85 | $26.92 | $50.12 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $15.85 Median $26.92 Typical High $50.12 | Professional | None | $15.85 | $26.92 | $50.12 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $50.12 | Professional | None | $39.81 | $50.12 | $50.12 |
United Setting Professional Modifier None Typical Low $18.20 Median $26.92 Typical High $35.48 | Professional | None | $18.20 | $26.92 | $35.48 |
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 $8.32 Median $8.32 Typical High $37.15 | Professional | 52 · Reduced service | $8.32 | $8.32 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.31 Typical High $14.79 | Professional | 53 · Discontinued | $3.31 | $3.31 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $11.22 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $1.66 Typical High $7.41 | Professional | 56 · Pre-op care only | $1.66 | $1.66 | $7.41 |
Where Ohio sits
The same service costs 4.3 times more in Alaska than in New York. 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· 13th of 51
$30.20
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.