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 $60.26 Median $134.90 Typical High $12,589.25 | Facility | None | $60.26 | $134.90 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $48.98 Typical High $134.90 | Professional | None | $31.62 | $48.98 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.77 Median $19.05 Typical High $58.88 | Professional | None | $9.77 | $19.05 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $851.14 Typical High $2,691.53 | Facility | None | $501.19 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $489.78 Median $851.14 Typical High $2,691.53 | Facility | None | $489.78 | $851.14 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $81.28 Typical High $109.65 | Professional | None | $47.86 | $81.28 | $109.65 |
SummaCare Setting Professional Modifier None Typical Low $26.92 Median $47.86 Typical High $66.07 | Professional | None | $26.92 | $47.86 | $66.07 |
United Setting Facility Modifier None Typical Low $97.72 Median $257.04 Typical High $2,398.83 | Facility | None | $97.72 | $257.04 | $2,398.83 |
United Setting Professional Modifier None Typical Low $27.54 Median $47.86 Typical High $102.33 | Professional | None | $27.54 | $47.86 | $102.33 |
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 $15.85 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $15.85 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $6.31 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $37.15 Typical High $37.15 | Professional | 54 · Surgery only | $23.99 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $4.79 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.16 | $4.90 | $4.90 |
Where Ohio sits
The same service costs 2.8 times more in Alaska than in California. 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· 50th of 51
$46.77
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.