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 $39.81 Median $39.81 Typical High $120.23 | Facility | None | $39.81 | $39.81 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $120.23 | Professional | None | $39.81 | $39.81 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $45.71 | Professional | None | $25.70 | $25.70 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $74.13 | Facility | None | $54.95 | $54.95 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $74.13 | Facility | None | $54.95 | $54.95 | $74.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
United Setting Professional Modifier None Typical Low $28.84 Median $70.79 Typical High $95.50 | Professional | None | $28.84 | $70.79 | $95.50 |
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 $19.50 Median $19.50 Typical High $60.26 | Professional | 52 · Reduced service | $19.50 | $19.50 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $23.99 | Professional | 53 · Discontinued | $7.94 | $7.94 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $18.20 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $12.02 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $12.02 |
Where Ohio sits
The same service costs 3.1 times more in Wisconsin than in New York. 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· 42nd of 51
$28.84
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.