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 $14.79 Median $14.79 Typical High $85.11 | Facility | None | $14.79 | $14.79 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $46.77 | Professional | None | $14.79 | $14.79 | $46.77 |
Ambetter Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $23.99 | Professional | None | $20.42 | $20.42 | $23.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.92 Median $9.55 Typical High $23.44 | Professional | None | $6.92 | $9.55 | $23.44 |
Aultcare Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
CareSource Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
CareSource Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $31.62 | Professional | None | $30.20 | $30.20 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $14.45 | Professional | None | $9.77 | $9.77 | $14.45 |
Molina Setting Professional Modifier None Typical Low $5.50 Median $7.59 Typical High $14.79 | Professional | None | $5.50 | $7.59 | $14.79 |
SummaCare Setting Professional Modifier None Typical Low $20.42 Median $25.12 Typical High $38.02 | Professional | None | $20.42 | $25.12 | $38.02 |
United Setting Professional Modifier None Typical Low $7.76 Median $11.48 Typical High $14.45 | Professional | None | $7.76 | $11.48 | $14.45 |
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 $7.41 Median $7.41 Typical High $22.91 | Professional | 52 · Reduced service | $7.41 | $7.41 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $2.95 Typical High $9.12 | Professional | 53 · Discontinued | $2.95 | $2.95 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.22 Median $11.22 Typical High $34.67 | Professional | 54 · Surgery only | $11.22 | $11.22 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.24 Typical High $6.92 | Professional | 55 · Aftercare only | $2.24 | $2.24 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.48 Typical High $4.57 | Professional | 56 · Pre-op care only | $1.48 | $1.48 | $4.57 |
Where Ohio sits
The same service costs 2.9 times more in Rhode Island 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
$9.77
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.