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 $104.71 Median $288.40 Typical High $354.81 | Facility | None | $104.71 | $288.40 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $323.59 | Professional | None | $104.71 | $104.71 | $323.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $199.53 | Professional | None | $123.03 | $151.36 | $199.53 |
CareSource Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $109.65 | Professional | None | $95.50 | $95.50 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $186.21 | Professional | None | $91.20 | $100.00 | $186.21 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $181.97 | Professional | None | $91.20 | $100.00 | $181.97 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $158.49 | Professional | None | $77.62 | $100.00 | $158.49 |
SummaCare Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $120.23 | Professional | None | $102.33 | $102.33 | $120.23 |
United Setting Facility Modifier None Typical Low $676.08 Median $794.33 Typical High $1,122.02 | Facility | None | $676.08 | $794.33 | $1,122.02 |
United Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $147.91 | Professional | None | $79.43 | $100.00 | $147.91 |
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 $52.48 Median $52.48 Typical High $72.44 | Professional | 52 · Reduced service | $52.48 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $28.84 | Professional | 53 · Discontinued | $20.89 | $20.89 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $21.38 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $14.45 |
Where Ohio sits
The same service costs 3.0 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· 35th of 51
$117
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.