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 $72.44 Median $72.44 Typical High $104.71 | Facility | None | $72.44 | $72.44 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $79.43 | Professional | None | $72.44 | $72.44 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $177.83 Typical High $489.78 | Facility | None | $81.28 | $177.83 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $109.65 | Professional | None | $56.23 | $56.23 | $109.65 |
CareSource Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Facility | None | $165.96 | $165.96 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | None | $77.62 | $77.62 | $91.20 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Facility | None | $165.96 | $165.96 | $223.87 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | None | $77.62 | $77.62 | $91.20 |
Molina Setting Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $81.28 | Professional | None | $61.66 | $69.18 | $81.28 |
SummaCare Setting Professional Modifier None Typical Low $83.18 Median $89.13 Typical High $158.49 | Professional | None | $83.18 | $89.13 | $158.49 |
United Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $112.20 | Professional | None | $75.86 | $75.86 | $112.20 |
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 $36.31 Median $36.31 Typical High $39.81 | Professional | 52 · Reduced service | $36.31 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $15.85 | Professional | 53 · Discontinued | $14.45 | $14.45 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $11.75 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $7.94 |
Where Ohio sits
The same service costs 25.1 times more in Alabama 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· 38th of 51
$75.86
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.