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 $79.43 Median $79.43 Typical High $309.03 | Facility | None | $79.43 | $79.43 | $309.03 |
Aetna Setting Professional Modifier None (both parts) Typical Low $79.43 Median $79.43 Typical High $275.42 | Professional | None (both parts) | $79.43 | $79.43 | $275.42 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $72.44 Median $85.11 Typical High $128.82 | Professional | None (both parts) | $72.44 | $85.11 | $128.82 |
Cigna Setting Professional Modifier None (both parts) Typical Low $79.43 Median $91.20 Typical High $190.55 | Professional | None (both parts) | $79.43 | $91.20 | $190.55 |
Medical Mutual of Ohio Setting Professional Modifier None (both parts) Typical Low $79.43 Median $91.20 Typical High $165.96 | Professional | None (both parts) | $79.43 | $91.20 | $165.96 |
Molina Setting Professional Modifier None (both parts) Typical Low $57.54 Median $83.18 Typical High $112.20 | Professional | None (both parts) | $57.54 | $83.18 | $112.20 |
SummaCare Setting Professional Modifier None (both parts) Typical Low $66.07 Median $72.44 Typical High $95.50 | Professional | None (both parts) | $66.07 | $72.44 | $95.50 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,258.93 | Facility | None | $758.58 | $891.25 | $1,258.93 |
United Setting Professional Modifier None (both parts) Typical Low $74.13 Median $95.50 Typical High $204.17 | Professional | None (both parts) | $74.13 | $95.50 | $204.17 |
6 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 $39.81 Median $39.81 Typical High $91.20 | Professional | 52 · Reduced service | $39.81 | $39.81 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $36.31 | Professional | 53 · Discontinued | $16.22 | $16.22 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $26.92 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $18.20 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $18.20 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $89.13 Median $93.33 Typical High $173.78 | Professional | TC · Technical part | $89.13 | $93.33 | $173.78 |
Medical Mutual of Ohio Setting Professional Modifier TC · Technical part Typical Low $89.13 Median $93.33 Typical High $173.78 | Professional | TC · Technical part | $89.13 | $93.33 | $173.78 |
Where Ohio sits
The same service costs 2.9 times more in Alaska than in Florida. 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· 45th of 51
$85.11
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.