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 $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $109.65 Typical High $302.00 | Facility | None | $50.12 | $109.65 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $177.83 | Professional | None | $97.72 | $125.89 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $138.04 | Facility | None | $102.33 | $102.33 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $56.23 | Professional | None | $47.86 | $47.86 | $56.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $138.04 | Facility | None | $102.33 | $102.33 | $138.04 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $56.23 | Professional | None | $47.86 | $47.86 | $56.23 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $263.03 | Professional | None | $173.78 | $251.19 | $263.03 |
SummaCare Setting Professional Modifier None Typical Low $48.98 Median $54.95 Typical High $97.72 | Professional | None | $48.98 | $54.95 | $97.72 |
United Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $69.18 | Professional | None | $46.77 | $46.77 | $69.18 |
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 $22.39 Median $22.39 Typical High $371.54 | Professional | 52 · Reduced service | $22.39 | $22.39 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $147.91 | Professional | 53 · Discontinued | $8.91 | $8.91 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $109.65 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $74.13 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $74.13 |
Where Ohio sits
The same service costs 3.9 times more in Hawaii than in South Carolina. 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
$107
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.