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 $57.54 Median $57.54 Typical High $549.54 | Facility | None | $57.54 | $57.54 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $354.81 | Professional | None | $57.54 | $57.54 | $354.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $125.89 | Professional | None | $64.57 | $89.13 | $125.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $56.23 Median $66.07 Typical High $91.20 | Professional | UE · Used equipment | $56.23 | $66.07 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $181.97 Typical High $208.93 | Professional | None | $17.78 | $181.97 | $208.93 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $17.78 Median $104.71 Typical High $104.71 | Professional | None | $17.78 | $104.71 | $104.71 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
United Setting Professional Modifier None Typical Low $41.69 Median $83.18 Typical High $112.20 | Professional | None | $41.69 | $83.18 | $112.20 |
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 $28.84 Median $28.84 Typical High $173.78 | Professional | 52 · Reduced service | $28.84 | $28.84 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $70.79 | Professional | 53 · Discontinued | $11.48 | $11.48 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $52.48 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $35.48 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $35.48 |
Where Ohio sits
The same service costs 18.2 times more in North Carolina than in New York. 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· 7th of 51
$89.13
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.