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 $114.82 Median $114.82 Typical High $436.52 | Facility | None | $114.82 | $114.82 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $436.52 | Professional | None | $114.82 | $114.82 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $123.03 Median $194.98 Typical High $302.00 | Facility | None | $123.03 | $194.98 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $204.17 | Professional | None | $89.13 | $89.13 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $263.03 Typical High $346.74 | Facility | None | $120.23 | $263.03 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $144.54 | Professional | None | $123.03 | $123.03 | $144.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $120.23 Median $263.03 Typical High $346.74 | Facility | None | $120.23 | $263.03 | $346.74 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $144.54 | Professional | None | $123.03 | $123.03 | $144.54 |
SummaCare Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $257.04 | Professional | None | $128.82 | $138.04 | $257.04 |
United Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
United Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $177.83 | Professional | None | $120.23 | $120.23 | $177.83 |
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 $57.54 Median $57.54 Typical High $218.78 | Professional | 52 · Reduced service | $57.54 | $57.54 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $87.10 | Professional | 53 · Discontinued | $22.91 | $22.91 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $64.57 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $43.65 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $43.65 |
Where Ohio sits
The same service costs 1.7 times more in Arizona than in Hawaii. 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· 14th of 51
$123
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.