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 $12.59 Median $34.67 Typical High $70.79 | Facility | None | $12.59 | $34.67 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $25.70 | Professional | None | $12.59 | $12.59 | $25.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.89 Median $8.13 Typical High $19.95 | Professional | None | $5.89 | $8.13 | $19.95 |
CareSource Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
CareSource Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $26.30 | Professional | None | $25.70 | $25.70 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Molina Setting Professional Modifier None Typical Low $4.68 Median $6.46 Typical High $12.59 | Professional | None | $4.68 | $6.46 | $12.59 |
SummaCare Setting Professional Modifier None Typical Low $16.98 Median $20.89 Typical High $27.54 | Professional | None | $16.98 | $20.89 | $27.54 |
United Setting Professional Modifier None Typical Low $6.61 Median $9.77 Typical High $12.59 | Professional | None | $6.61 | $9.77 | $12.59 |
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 $6.31 Median $6.31 Typical High $14.13 | Professional | 52 · Reduced service | $6.31 | $6.31 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.51 Typical High $5.62 | Professional | 53 · Discontinued | $2.51 | $2.51 | $5.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.33 Median $9.33 Typical High $20.89 | Professional | 54 · Surgery only | $9.33 | $9.33 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $1.86 Typical High $4.17 | Professional | 55 · Aftercare only | $1.86 | $1.86 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $1.26 Typical High $2.82 | Professional | 56 · Pre-op care only | $1.26 | $1.26 | $2.82 |
Where Ohio sits
The same service costs 2.8 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
$8.13
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.