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 $20.42 Median $20.42 Typical High $162.18 | Facility | None | $20.42 | $20.42 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $47.86 | Professional | None | $20.42 | $20.42 | $47.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $19.50 Typical High $30.90 | Professional | None | $16.60 | $19.50 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $21.38 Typical High $47.86 | Professional | None | $19.50 | $21.38 | $47.86 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $19.50 Median $21.38 Typical High $42.66 | Professional | None | $19.50 | $21.38 | $42.66 |
Molina Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
SummaCare Setting Professional Modifier None Typical Low $16.98 Median $18.62 Typical High $24.55 | Professional | None | $16.98 | $18.62 | $24.55 |
United Setting Facility Modifier None Typical Low $446.68 Median $512.86 Typical High $741.31 | Facility | None | $446.68 | $512.86 | $741.31 |
United Setting Professional Modifier None Typical Low $17.38 Median $22.91 Typical High $50.12 | Professional | None | $17.38 | $22.91 | $50.12 |
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 $10.23 Median $10.23 Typical High $22.91 | Professional | 52 · Reduced service | $10.23 | $10.23 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $9.12 | Professional | 53 · Discontinued | $4.07 | $4.07 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.09 Typical High $6.92 | Professional | 55 · Aftercare only | $3.09 | $3.09 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $4.57 |
Where Ohio sits
The same service costs 2.8 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· 49th of 51
$20.42
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.