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 $602.56 Median $691.83 Typical High $691.83 | Facility | None | $602.56 | $691.83 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $691.83 | Professional | None | $660.69 | $691.83 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $501.19 Typical High $676.08 | Professional | None | $208.93 | $501.19 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
SummaCare Setting Professional Modifier None Typical Low $70.79 Median $288.40 Typical High $524.81 | Professional | None | $70.79 | $288.40 | $524.81 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $4,897.79 Typical High $7,079.46 | Facility | None | $4,265.80 | $4,897.79 | $7,079.46 |
United Setting Professional Modifier None Typical Low $60.26 Median $128.82 Typical High $316.23 | Professional | None | $60.26 | $128.82 | $316.23 |
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 $323.59 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $323.59 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $131.83 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $97.72 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $66.07 | $69.18 | $69.18 |
Where Ohio sits
The same service costs 7.6 times more in Colorado than in Rhode Island. 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· 23rd of 51
$219
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.