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 $109.65 Median $109.65 Typical High $724.44 | Facility | None | $109.65 | $109.65 | $724.44 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $549.54 | Professional | None | $109.65 | $109.65 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $181.97 Typical High $331.13 | Facility | None | $112.20 | $181.97 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $173.78 | Professional | None | $107.15 | $109.65 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
CareSource Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $234.42 Typical High $363.08 | Facility | None | $208.93 | $234.42 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $131.83 | Professional | None | $109.65 | $109.65 | $131.83 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $199.53 Median $234.42 Typical High $316.23 | Facility | None | $199.53 | $234.42 | $316.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $131.83 | Professional | None | $109.65 | $109.65 | $131.83 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $154.88 | Professional | None | $114.82 | $138.04 | $154.88 |
SummaCare Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $218.78 | Professional | None | $109.65 | $120.23 | $218.78 |
United Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
United Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $154.88 | Professional | None | $104.71 | $104.71 | $154.88 |
5 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 $54.95 Median $54.95 Typical High $275.42 | Professional | 52 · Reduced service | $54.95 | $54.95 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $109.65 | Professional | 53 · Discontinued | $21.88 | $21.88 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $416.87 | Professional | 54 · Surgery only | $83.18 | $83.18 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $83.18 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $54.95 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $54.95 |
Where Ohio sits
The same service costs 5.0 times more in Alabama than in Maryland. 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· 6th of 51
$132
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.