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 $17.38 Median $389.05 Typical High $1,148.15 | Facility | None | $17.38 | $389.05 | $1,148.15 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $389.05 Typical High $389.05 | Professional | None | $17.38 | $389.05 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $114.82 Typical High $389.05 | Professional | None | $23.99 | $114.82 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $131.83 Typical High $512.86 | Professional | None | $15.14 | $131.83 | $512.86 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $15.14 Median $131.83 Typical High $501.19 | Professional | None | $15.14 | $131.83 | $501.19 |
Molina Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $630.96 | Professional | None | $316.23 | $436.52 | $630.96 |
SummaCare Setting Professional Modifier None Typical Low $15.85 Median $43.65 Typical High $446.68 | Professional | None | $15.85 | $43.65 | $446.68 |
United Setting Facility Modifier None Typical Low $416.87 Median $478.63 Typical High $676.08 | Facility | None | $416.87 | $478.63 | $676.08 |
United Setting Professional Modifier None Typical Low $15.14 Median $69.18 Typical High $371.54 | Professional | None | $15.14 | $69.18 | $371.54 |
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 $8.71 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $8.71 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $3.47 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $2.57 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $1.74 | $38.90 | $38.90 |
Where Ohio sits
The same service costs 28.2 times more in Hawaii than in Washington, DC. 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· 23rd of 51
$155
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.