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 $11.48 Median $11.48 Typical High $109.65 | Facility | None | $11.48 | $11.48 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $27.54 | Professional | None | $11.48 | $11.48 | $27.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.37 Median $7.41 Typical High $18.20 | Professional | None | $5.37 | $7.41 | $18.20 |
CareSource Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
CareSource Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $24.55 | Professional | None | $23.44 | $23.44 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Molina Setting Professional Modifier None Typical Low $4.27 Median $5.89 Typical High $11.48 | Professional | None | $4.27 | $5.89 | $11.48 |
SummaCare Setting Professional Modifier None Typical Low $15.49 Median $19.50 Typical High $25.12 | Professional | None | $15.49 | $19.50 | $25.12 |
United Setting Professional Modifier None Typical Low $6.03 Median $8.91 Typical High $11.48 | Professional | None | $6.03 | $8.91 | $11.48 |
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 $5.75 Median $5.75 Typical High $16.60 | Professional | 52 · Reduced service | $5.75 | $5.75 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $6.61 | Professional | 53 · Discontinued | $2.29 | $2.29 | $6.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.51 Median $8.51 Typical High $24.55 | Professional | 54 · Surgery only | $8.51 | $8.51 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $4.90 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.15 Typical High $3.31 | Professional | 56 · Pre-op care only | $1.15 | $1.15 | $3.31 |
Where Ohio sits
The same service costs 2.7 times more in Idaho 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· 48th of 51
$7.59
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.