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 $46.77 Median $46.77 Typical High $141.25 | Facility | None | $46.77 | $46.77 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $89.13 | Professional | None | $46.77 | $46.77 | $89.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.88 Median $30.20 Typical High $74.13 | Professional | None | $21.88 | $30.20 | $74.13 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
CareSource Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $100.00 | Professional | None | $95.50 | $95.50 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Molina Setting Professional Modifier None Typical Low $17.38 Median $23.99 Typical High $46.77 | Professional | None | $17.38 | $23.99 | $46.77 |
SummaCare Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $102.33 | Professional | None | $64.57 | $79.43 | $102.33 |
United Setting Professional Modifier None Typical Low $24.55 Median $36.31 Typical High $46.77 | Professional | None | $24.55 | $36.31 | $46.77 |
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 $23.44 Median $23.44 Typical High $44.67 | Professional | 52 · Reduced service | $23.44 | $23.44 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $18.20 | Professional | 53 · Discontinued | $9.33 | $9.33 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $35.48 Typical High $67.61 | Professional | 54 · Surgery only | $35.48 | $35.48 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $13.49 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $8.91 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $8.91 |
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· 49th of 51
$30.90
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.