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 $28.84 Median $29.51 Typical High $199.53 | Facility | None | $28.84 | $29.51 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $29.51 Typical High $64.57 | Professional | None | $28.84 | $29.51 | $64.57 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $51.29 Typical High $72.44 | Professional | None | $26.30 | $51.29 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $48.98 Typical High $87.10 | Professional | None | $36.31 | $48.98 | $87.10 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $36.31 Median $48.98 Typical High $87.10 | Professional | None | $36.31 | $48.98 | $87.10 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $41.69 Typical High $56.23 | Professional | None | $23.44 | $41.69 | $56.23 |
SummaCare Setting Professional Modifier None Typical Low $33.88 Median $39.81 Typical High $52.48 | Professional | None | $33.88 | $39.81 | $52.48 |
United Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $85.11 | Professional | None | $41.69 | $52.48 | $85.11 |
3 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 $14.13 Median $14.79 Typical High $53.70 | Professional | 52 · Reduced service | $14.13 | $14.79 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.47 Typical High $16.22 | Professional | 55 · Aftercare only | $4.27 | $4.47 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.95 Typical High $10.72 | Professional | 56 · Pre-op care only | $2.88 | $2.95 | $10.72 |
Where Ohio sits
The same service costs 2.6 times more in Nebraska 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· 39th of 51
$47.86
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.