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 $28.18 Median $28.18 Typical High $91.20 | Facility | None | $28.18 | $28.18 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $58.88 | Professional | None | $28.18 | $28.18 | $58.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $18.20 Typical High $44.67 | Professional | None | $13.18 | $18.20 | $44.67 |
CareSource Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
CareSource Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $58.88 | Professional | None | $57.54 | $57.54 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Molina Setting Professional Modifier None Typical Low $10.47 Median $14.45 Typical High $28.18 | Professional | None | $10.47 | $14.45 | $28.18 |
SummaCare Setting Professional Modifier None Typical Low $38.02 Median $46.77 Typical High $61.66 | Professional | None | $38.02 | $46.77 | $61.66 |
United Setting Professional Modifier None Typical Low $14.45 Median $21.88 Typical High $27.54 | Professional | None | $14.45 | $21.88 | $27.54 |
5 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 $13.80 Median $13.80 Typical High $29.51 | Professional | 52 · Reduced service | $13.80 | $13.80 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $11.75 | Professional | 53 · Discontinued | $5.62 | $5.62 | $11.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.89 Median $20.89 Typical High $44.67 | Professional | 54 · Surgery only | $20.89 | $20.89 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.17 Typical High $8.91 | Professional | 55 · Aftercare only | $4.17 | $4.17 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $5.89 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $5.89 |
Where Ohio sits
The same service costs 2.7 times more in Hawaii than in New York. 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· 50th of 51
$18.20
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.