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 $38.02 Median $38.02 Typical High $85.11 | Facility | None | $38.02 | $38.02 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $85.11 | Professional | None | $38.02 | $38.02 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.90 Median $61.66 Typical High $95.50 | Facility | None | $38.90 | $61.66 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $69.18 | Professional | None | $30.20 | $30.20 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $117.49 | Facility | None | $87.10 | $87.10 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $47.86 | Professional | None | $40.74 | $40.74 | $47.86 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $117.49 | Facility | None | $87.10 | $87.10 | $117.49 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $47.86 | Professional | None | $40.74 | $40.74 | $47.86 |
SummaCare Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $85.11 | Professional | None | $42.66 | $46.77 | $85.11 |
United Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $58.88 | Professional | None | $39.81 | $39.81 | $58.88 |
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 $19.05 Median $19.05 Typical High $42.66 | Professional | 52 · Reduced service | $19.05 | $19.05 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $17.38 | Professional | 53 · Discontinued | $7.59 | $7.59 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $12.88 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $8.51 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $8.51 |
Where Ohio sits
The same service costs 1.8 times more in Alaska than in Nebraska. 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· 32nd of 51
$40.74
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.