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 $93.33 Median $93.33 Typical High $208.93 | Facility | None | $93.33 | $93.33 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $102.33 | Professional | None | $93.33 | $93.33 | $102.33 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $79.43 Typical High $107.15 | Professional | None | $69.18 | $79.43 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $128.82 | Professional | None | $64.57 | $89.13 | $128.82 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $144.54 | Professional | None | $89.13 | $97.72 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $45.71 Typical High $52.48 | Professional | None | $44.67 | $45.71 | $52.48 |
SummaCare Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $114.82 | Professional | None | $89.13 | $93.33 | $114.82 |
United Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $107.15 | Facility | None | $77.62 | $87.10 | $107.15 |
United Setting Professional Modifier None Typical Low $72.44 Median $89.13 Typical High $125.89 | Professional | None | $72.44 | $89.13 | $125.89 |
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 $46.77 Median $46.77 Typical High $51.29 | Professional | 52 · Reduced service | $46.77 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $20.42 | Professional | 53 · Discontinued | $18.62 | $18.62 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $15.49 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $10.23 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $10.23 |
Where Ohio sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 39th of 51
$89.13
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.