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 $57.54 Median $158.49 Typical High $407.38 | Facility | None | $57.54 | $158.49 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $407.38 | Professional | None | $57.54 | $57.54 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $338.84 Typical High $562.34 | Professional | None | $331.13 | $338.84 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $239.88 | Facility | None | $177.83 | $177.83 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $239.88 | Facility | None | $177.83 | $177.83 | $239.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
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 $28.18 Median $57.54 Typical High $91.20 | Professional | None | $28.18 | $57.54 | $91.20 |
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 $204.17 | Professional | 52 · Reduced service | $28.84 | $28.84 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $81.28 | Professional | 53 · Discontinued | $11.48 | $11.48 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $61.66 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $40.74 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $40.74 |
Where Ohio sits
The same service costs 5.0 times more in Ohio than in Hawaii. 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· 1st of 51
$282
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.