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 $51.29 Median $51.29 Typical High $426.58 | Facility | None | $51.29 | $51.29 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $407.38 | Professional | None | $51.29 | $51.29 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $57.54 Median $123.03 Typical High $346.74 | Facility | None | $57.54 | $123.03 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $47.86 Typical High $75.86 | Professional | None | $40.74 | $47.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $154.88 | Facility | None | $114.82 | $114.82 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $63.10 | Professional | None | $53.70 | $53.70 | $63.10 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $154.88 | Facility | None | $114.82 | $114.82 | $154.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $63.10 | Professional | None | $53.70 | $53.70 | $63.10 |
SummaCare Setting Professional Modifier None Typical Low $58.88 Median $61.66 Typical High $112.20 | Professional | None | $58.88 | $61.66 | $112.20 |
United Setting Facility Modifier None Typical Low $70.79 Median $83.18 Typical High $117.49 | Facility | None | $70.79 | $83.18 | $117.49 |
United Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $77.62 | Professional | None | $52.48 | $52.48 | $77.62 |
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 $25.12 Median $25.12 Typical High $204.17 | Professional | 52 · Reduced service | $25.12 | $25.12 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $81.28 | Professional | 53 · Discontinued | $10.23 | $10.23 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $61.66 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $40.74 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $40.74 |
Where Ohio sits
The same service costs 6.6 times more in Alabama than in Kansas. 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· 11th of 51
$53.70
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.