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 $3.02 Median $8.32 Typical High $10.00 | Facility | None | $3.02 | $8.32 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $69.18 | Professional | None | $3.02 | $3.02 | $69.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.51 Median $1.51 Typical High $34.67 | Professional | 52 · Reduced service | $1.51 | $1.51 | $34.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $199.53 | Professional | None | $120.23 | $158.49 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Molina Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $154.88 | Professional | None | $87.10 | $87.10 | $154.88 |
SummaCare Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $144.54 | Professional | None | $112.20 | $117.49 | $144.54 |
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 53 · Discontinued Typical Low $13.80 Median $16.98 Typical High $21.88 | Professional | 53 · Discontinued | $13.80 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.88 Typical High $16.60 | Professional | 55 · Aftercare only | $10.47 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.51 Typical High $10.96 | Professional | 56 · Pre-op care only | $6.92 | $8.51 | $10.96 |
Where Ohio sits
The same service costs 83.2 times more in North Dakota than in Kansas. 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· 28th of 51
$102
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.