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 $83.18 Median $83.18 Typical High $302.00 | Facility | None | $83.18 | $83.18 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $229.09 | Professional | None | $83.18 | $83.18 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $204.17 Typical High $562.34 | Facility | None | $93.33 | $204.17 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $91.20 Typical High $169.82 | Professional | None | $87.10 | $91.20 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $257.04 | Facility | None | $190.55 | $190.55 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $104.71 | Professional | None | $89.13 | $89.13 | $104.71 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $257.04 | Facility | None | $190.55 | $190.55 | $257.04 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $104.71 | Professional | None | $89.13 | $89.13 | $104.71 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $131.83 | Professional | None | $100.00 | $114.82 | $131.83 |
SummaCare Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $181.97 | Professional | None | $91.20 | $100.00 | $181.97 |
United Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $128.82 | Professional | None | $87.10 | $87.10 | $128.82 |
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 $41.69 Median $41.69 Typical High $114.82 | Professional | 52 · Reduced service | $41.69 | $41.69 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $45.71 | Professional | 53 · Discontinued | $16.60 | $16.60 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $33.88 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $22.91 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $22.91 |
Where Ohio sits
The same service costs 1.6 times more in Alaska than in Texas. 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· 17th of 51
$91.20
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.