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 $51.29 Median $51.29 Typical High $323.59 | Facility | None | $51.29 | $51.29 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $323.59 | Professional | None | $51.29 | $51.29 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.03 Typical High $0.07 | Facility | None | $0.02 | $0.03 | $0.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $87.10 | Professional | None | $51.29 | $60.26 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Facility | None | $117.49 | $117.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $64.57 | Professional | None | $54.95 | $54.95 | $64.57 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Facility | None | $117.49 | $117.49 | $158.49 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $64.57 | Professional | None | $54.95 | $54.95 | $64.57 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $87.10 | Professional | None | $66.07 | $74.13 | $87.10 |
United Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $83.18 | Professional | None | $56.23 | $56.23 | $83.18 |
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 $25.70 Median $25.70 Typical High $162.18 | Professional | 52 · Reduced service | $25.70 | $25.70 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $66.07 | Professional | 53 · Discontinued | $10.23 | $10.23 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $48.98 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $32.36 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $32.36 |
Where Ohio sits
The same service costs 1.6 times more in Arizona 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· 9th of 51
$60.26
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.