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 $21.38 Median $21.38 Typical High $125.89 | Facility | None | $21.38 | $21.38 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $79.43 | Professional | None | $21.38 | $21.38 | $79.43 |
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 |
CareSource Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
CareSource Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $45.71 | Professional | None | $43.65 | $43.65 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
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 $29.51 Median $36.31 Typical High $46.77 | Professional | None | $29.51 | $36.31 | $46.77 |
United Setting Professional Modifier None Typical Low $11.22 Median $16.60 Typical High $21.38 | Professional | None | $11.22 | $16.60 | $21.38 |
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 $10.72 Median $10.72 Typical High $39.81 | Professional | 52 · Reduced service | $10.72 | $10.72 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $15.85 | Professional | 53 · Discontinued | $4.27 | $4.27 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $16.22 Typical High $60.26 | Professional | 54 · Surgery only | $16.22 | $16.22 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $12.02 | Professional | 55 · Aftercare only | $3.24 | $3.24 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.14 Typical High $7.94 | Professional | 56 · Pre-op care only | $2.14 | $2.14 | $7.94 |
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
$14.13
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.