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 $26.30 Median $26.30 Typical High $128.82 | Facility | None | $26.30 | $26.30 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $81.28 | Professional | None | $26.30 | $26.30 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.59 Median $17.38 Typical High $42.66 | Professional | None | $12.59 | $17.38 | $42.66 |
CareSource Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
CareSource Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $56.23 | Professional | None | $54.95 | $54.95 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Molina Setting Professional Modifier None Typical Low $10.00 Median $13.80 Typical High $26.92 | Professional | None | $10.00 | $13.80 | $26.92 |
SummaCare Setting Professional Modifier None Typical Low $36.31 Median $44.67 Typical High $58.88 | Professional | None | $36.31 | $44.67 | $58.88 |
United Setting Professional Modifier None Typical Low $13.80 Median $20.89 Typical High $26.30 | Professional | None | $13.80 | $20.89 | $26.30 |
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 $13.18 Median $13.18 Typical High $40.74 | Professional | 52 · Reduced service | $13.18 | $13.18 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $16.22 | Professional | 53 · Discontinued | $5.37 | $5.37 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $19.95 Typical High $61.66 | Professional | 54 · Surgery only | $19.95 | $19.95 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $12.30 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $8.13 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $8.13 |
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
$17.38
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.