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 $40.74 Median $40.74 Typical High $151.36 | Facility | None | $40.74 | $40.74 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $43.65 | Professional | None | $40.74 | $40.74 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.03 Typical High $0.07 | Facility | None | $0.02 | $0.03 | $0.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $58.88 | Professional | None | $40.74 | $40.74 | $58.88 |
CareSource Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
CareSource Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $33.11 | Professional | None | $30.90 | $30.90 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $87.10 | Facility | None | $64.57 | $64.57 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $87.10 | Facility | None | $64.57 | $64.57 | $87.10 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | None | $50.12 | $70.79 | $70.79 |
United Setting Professional Modifier None Typical Low $37.15 Median $41.69 Typical High $45.71 | Professional | None | $37.15 | $41.69 | $45.71 |
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 $20.42 Median $20.42 Typical High $21.88 | Professional | 52 · Reduced service | $20.42 | $20.42 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $8.71 | Professional | 53 · Discontinued | $8.13 | $8.13 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $6.46 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $4.37 |
Where Ohio sits
The same service costs 2.0 times more in Alaska than in New Mexico. 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· 39th 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.