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 $26.92 Median $26.92 Typical High $131.83 | Facility | None | $26.92 | $26.92 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $53.70 | Professional | None | $26.92 | $26.92 | $53.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.59 Median $17.38 Typical High $43.65 | Professional | None | $12.59 | $17.38 | $43.65 |
Aultcare Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
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 $57.54 | Professional | None | $54.95 | $54.95 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Molina Setting Professional Modifier None Typical Low $10.23 Median $13.80 Typical High $27.54 | Professional | None | $10.23 | $13.80 | $27.54 |
SummaCare Setting Professional Modifier None Typical Low $37.15 Median $45.71 Typical High $60.26 | Professional | None | $37.15 | $45.71 | $60.26 |
United Setting Professional Modifier None Typical Low $14.13 Median $20.89 Typical High $26.30 | Professional | None | $14.13 | $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 $13.49 Median $13.49 Typical High $41.69 | Professional | 52 · Reduced service | $13.49 | $13.49 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $16.60 | Professional | 53 · Discontinued | $5.37 | $5.37 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.42 Median $20.42 Typical High $61.66 | Professional | 54 · Surgery only | $20.42 | $20.42 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $12.59 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $8.32 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $8.32 |
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
$17.78
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.