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 $53.70 Median $53.70 Typical High $213.80 | Facility | None | $53.70 | $53.70 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $128.82 | Professional | None | $53.70 | $53.70 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $34.67 Typical High $85.11 | Professional | None | $25.12 | $34.67 | $85.11 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $112.20 | Professional | None | $109.65 | $109.65 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $27.54 Typical High $53.70 | Professional | None | $19.95 | $27.54 | $53.70 |
SummaCare Setting Professional Modifier None Typical Low $72.44 Median $89.13 Typical High $117.49 | Professional | None | $72.44 | $89.13 | $117.49 |
United Setting Professional Modifier None Typical Low $27.54 Median $41.69 Typical High $51.29 | Professional | None | $27.54 | $41.69 | $51.29 |
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 $26.30 Median $26.30 Typical High $67.61 | Professional | 52 · Reduced service | $26.30 | $26.30 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $26.92 | Professional | 53 · Discontinued | $10.72 | $10.72 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $39.81 Typical High $102.33 | Professional | 54 · Surgery only | $39.81 | $39.81 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $20.42 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $13.49 |
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
$34.67
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.