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 $93.33 Median $93.33 Typical High $436.52 | Facility | None | $93.33 | $93.33 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $281.84 | Professional | None | $93.33 | $93.33 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $147.91 | Professional | None | $43.65 | $60.26 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | None | $190.55 | $190.55 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $47.86 Typical High $93.33 | Professional | None | $34.67 | $47.86 | $93.33 |
SummaCare Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $204.17 | Professional | None | $128.82 | $158.49 | $204.17 |
United Setting Professional Modifier None Typical Low $48.98 Median $72.44 Typical High $93.33 | Professional | None | $48.98 | $72.44 | $93.33 |
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 $46.77 Median $46.77 Typical High $141.25 | Professional | 52 · Reduced service | $46.77 | $46.77 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $56.23 | Professional | 53 · Discontinued | $18.62 | $18.62 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $70.79 Typical High $208.93 | Professional | 54 · Surgery only | $70.79 | $70.79 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $41.69 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $28.18 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $28.18 |
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
$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.