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 $104.71 Median $104.71 Typical High $446.68 | Facility | None | $104.71 | $104.71 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $269.15 | Professional | None | $104.71 | $104.71 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $165.96 | Professional | None | $91.20 | $107.15 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $229.09 | Professional | None | $107.15 | $123.03 | $229.09 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $218.78 | Professional | None | $109.65 | $123.03 | $218.78 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $162.18 | Professional | None | $83.18 | $120.23 | $162.18 |
SummaCare Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $134.90 | Professional | None | $97.72 | $109.65 | $134.90 |
United Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $257.04 | Professional | None | $93.33 | $117.49 | $257.04 |
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 $51.29 Median $51.29 Typical High $114.82 | Professional | 52 · Reduced service | $51.29 | $51.29 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $45.71 | Professional | 53 · Discontinued | $20.89 | $20.89 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $33.88 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $22.91 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $22.91 |
Where Ohio sits
The same service costs 2.8 times more in Alaska than in Texas. 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· 44th of 51
$110
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.