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 $2.57 Median $2.57 Typical High $50.12 | Facility | None | $2.57 | $2.57 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $38.02 | Professional | None | $2.57 | $2.57 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $19.50 | Professional | None | $11.48 | $11.48 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $10.72 | Facility | None | $7.94 | $7.94 | $10.72 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $10.72 | Facility | None | $7.94 | $7.94 | $10.72 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
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 $1.58 Median $2.69 Typical High $7.59 | Professional | None | $1.58 | $2.69 | $7.59 |
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 $1.29 Median $1.29 Typical High $19.05 | Professional | 52 · Reduced service | $1.29 | $1.29 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.51 Median $0.51 Typical High $7.59 | Professional | 53 · Discontinued | $0.51 | $0.51 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.38 Median $0.38 Typical High $5.75 | Professional | 55 · Aftercare only | $0.38 | $0.38 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.26 Typical High $3.80 | Professional | 56 · Pre-op care only | $0.26 | $0.26 | $3.80 |
Where Ohio sits
The same service costs 4.6 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
$11.48
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.