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 $45.71 Median $54.95 Typical High $165.96 | Facility | None | $45.71 | $54.95 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $53.70 Median $107.15 Typical High $331.13 | Facility | None | $53.70 | $107.15 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $38.02 | Professional | None | $8.91 | $8.91 | $38.02 |
CareSource Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $112.20 Typical High $147.91 | Facility | None | $51.29 | $112.20 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $51.29 Median $112.20 Typical High $147.91 | Facility | None | $51.29 | $112.20 | $147.91 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Molina Setting Professional Modifier None Typical Low $8.91 Median $9.77 Typical High $11.48 | Professional | None | $8.91 | $9.77 | $11.48 |
SummaCare Setting Professional Modifier None Typical Low $52.48 Median $54.95 Typical High $64.57 | Professional | None | $52.48 | $54.95 | $64.57 |
United Setting Professional Modifier None Typical Low $45.71 Median $51.29 Typical High $56.23 | Professional | None | $45.71 | $51.29 | $56.23 |
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 $24.55 Median $24.55 Typical High $25.70 | Professional | 52 · Reduced service | $24.55 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $10.47 | Professional | 53 · Discontinued | $9.77 | $9.77 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $7.76 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $5.25 |
Where Ohio sits
The same service costs 6.6 times more in Alaska than in Hawaii. 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· 42nd of 51
$50.12
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.