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 $104.71 Median $104.71 Typical High $1,023.29 | Facility | None | $104.71 | $104.71 | $1,023.29 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $1,096.48 | Professional | None | $104.71 | $104.71 | $1,096.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $162.18 | Professional | None | $89.13 | $112.20 | $162.18 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $50.12 | Professional | None | $39.81 | $50.12 | $50.12 |
United Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $190.55 | Professional | None | $128.82 | $128.82 | $190.55 |
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 $51.29 Median $51.29 Typical High $549.54 | Professional | 52 · Reduced service | $51.29 | $51.29 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $218.78 | Professional | 53 · Discontinued | $20.89 | $20.89 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $162.18 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $109.65 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $109.65 |
Where Ohio sits
The same service costs 3.7 times more in Alaska than in Arkansas. 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· 40th of 51
$112
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.