How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $30.90 Median $30.90 Typical High $229.09 | Facility | None | $30.90 | $30.90 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $63.10 | Professional | None | $30.90 | $30.90 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $125.89 | Professional | None | $83.18 | $83.18 | $125.89 |
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 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 $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Professional Modifier None Typical Low $50.12 Median $60.26 Typical High $70.79 | Professional | None | $50.12 | $60.26 | $70.79 |
United Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $61.66 | Professional | None | $60.26 | $61.66 | $61.66 |
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 $15.49 Median $15.49 Typical High $31.62 | Professional | 52 · Reduced service | $15.49 | $15.49 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $12.59 | Professional | 53 · Discontinued | $6.17 | $6.17 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $9.55 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $6.31 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $6.31 |
Where Ohio sits
The same service costs 4.6 times more in New York than in North Carolina. 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· 16th of 51
$61.66
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.