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 $100.00 Median $100.00 Typical High $213.80 | Facility | None | $100.00 | $100.00 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $177.83 | Professional | None | $100.00 | $100.00 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $263.03 | Professional | None | $87.10 | $109.65 | $263.03 |
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 $67.61 Median $81.28 Typical High $107.15 | Professional | None | $67.61 | $81.28 | $107.15 |
SummaCare Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
United Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $186.21 | Professional | None | $75.86 | $107.15 | $186.21 |
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 $50.12 Median $50.12 Typical High $87.10 | Professional | 52 · Reduced service | $50.12 | $50.12 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $35.48 | Professional | 53 · Discontinued | $19.95 | $19.95 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $26.30 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $17.78 |
Where Ohio sits
The same service costs 3.0 times more in Alaska than in West Virginia. 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· 49th 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.