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 $19.95 Median $56.23 Typical High $67.61 | Facility | None | $19.95 | $56.23 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $46.77 | Professional | None | $19.95 | $19.95 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.95 Median $32.36 Typical High $50.12 | Facility | None | $19.95 | $32.36 | $50.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.05 Median $28.84 Typical High $44.67 | Professional | None | $19.05 | $28.84 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $61.66 | Facility | None | $45.71 | $45.71 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | None | $21.38 | $21.38 | $25.12 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $61.66 | Facility | None | $45.71 | $45.71 | $61.66 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | None | $21.38 | $21.38 | $25.12 |
United Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
5 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 $10.00 Median $10.00 Typical High $23.44 | Professional | 52 · Reduced service | $10.00 | $10.00 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $9.33 | Professional | 53 · Discontinued | $4.07 | $4.07 | $9.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.14 Median $15.14 Typical High $35.48 | Professional | 54 · Surgery only | $15.14 | $15.14 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $7.08 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $4.68 |
Where Ohio sits
The same service costs 39.8 times more in Alabama than in Georgia. 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
$30.20
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.