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 $29.51 Median $29.51 Typical High $109.65 | Facility | None | $29.51 | $29.51 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $81.28 | Professional | None | $29.51 | $29.51 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.90 Median $50.12 Typical High $91.20 | Facility | None | $30.90 | $50.12 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $29.51 Typical High $54.95 | Professional | None | $28.84 | $29.51 | $54.95 |
CareSource Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
CareSource Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $64.57 Typical High $97.72 | Facility | None | $56.23 | $64.57 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $35.48 | Professional | None | $29.51 | $29.51 | $35.48 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $53.70 Median $64.57 Typical High $85.11 | Facility | None | $53.70 | $64.57 | $85.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $35.48 | Professional | None | $29.51 | $29.51 | $35.48 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $37.15 Typical High $41.69 | Professional | None | $31.62 | $37.15 | $41.69 |
SummaCare Setting Professional Modifier None Typical Low $29.51 Median $32.36 Typical High $58.88 | Professional | None | $29.51 | $32.36 | $58.88 |
United Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
United Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $42.66 | Professional | None | $28.84 | $28.84 | $42.66 |
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 $14.79 Median $14.79 Typical High $40.74 | Professional | 52 · Reduced service | $14.79 | $14.79 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $16.22 | Professional | 53 · Discontinued | $5.89 | $5.89 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $22.39 Typical High $61.66 | Professional | 54 · Surgery only | $22.39 | $22.39 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $12.30 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $8.13 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $8.13 |
Where Ohio sits
The same service costs 1.9 times more in Alaska than in Oklahoma. 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
$35.48
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.