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 $30.90 Median $56.23 Typical High $173.78 | Facility | None | $30.90 | $56.23 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $173.78 | Professional | None | $30.90 | $30.90 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.39 Median $26.92 Typical High $37.15 | Professional | None | $22.39 | $26.92 | $37.15 |
CareSource Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
CareSource Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $93.33 | Facility | None | $70.79 | $70.79 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | None | $32.36 | $32.36 | $38.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $93.33 | Facility | None | $70.79 | $70.79 | $93.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | None | $32.36 | $32.36 | $38.02 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $50.12 | Professional | None | $39.81 | $50.12 | $50.12 |
United Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $47.86 | Professional | None | $32.36 | $32.36 | $47.86 |
4 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 $15.49 Median $15.49 Typical High $87.10 | Professional | 52 · Reduced service | $15.49 | $15.49 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $34.67 | Professional | 53 · Discontinued | $6.17 | $6.17 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $25.70 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $17.38 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $17.38 |
Where Ohio sits
The same service costs 1.9 times more in Alaska than in Connecticut. 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· 24th of 51
$32.36
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.