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 $20.89 Median $20.89 Typical High $85.11 | Facility | None | $20.89 | $20.89 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.89 Typical High $41.69 | Professional | None | $20.42 | $20.89 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $13.80 Typical High $33.88 | Professional | None | $10.00 | $13.80 | $33.88 |
Aultcare Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
CareSource Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
CareSource Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $44.67 | Professional | None | $42.66 | $42.66 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $20.42 | Professional | None | $13.80 | $13.80 | $20.42 |
Molina Setting Professional Modifier None Typical Low $7.94 Median $10.96 Typical High $21.38 | Professional | None | $7.94 | $10.96 | $21.38 |
SummaCare Setting Professional Modifier None Typical Low $28.84 Median $35.48 Typical High $46.77 | Professional | None | $28.84 | $35.48 | $46.77 |
United Setting Professional Modifier None Typical Low $10.96 Median $16.22 Typical High $20.42 | Professional | None | $10.96 | $16.22 | $20.42 |
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 $10.47 Median $10.47 Typical High $21.88 | Professional | 52 · Reduced service | $10.47 | $10.47 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $8.71 | Professional | 53 · Discontinued | $4.17 | $4.17 | $8.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.85 Median $15.85 Typical High $33.11 | Professional | 54 · Surgery only | $15.85 | $15.85 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $6.61 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $4.37 |
Where Ohio sits
The same service costs 2.6 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
$13.80
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.