How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $42.66 Median $42.66 Typical High $3,715.35 | Facility | None | $42.66 | $42.66 | $3,715.35 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $45.71 | Professional | None | $42.66 | $42.66 | $45.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.70 Median $2.34 Typical High $5.37 | Professional | None | $1.70 | $2.34 | $5.37 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $194.98 Typical High $389.05 | Facility | None | $125.89 | $194.98 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $316.23 | Facility | None | $125.89 | $177.83 | $316.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Facility Modifier None Typical Low $134.90 Median $141.25 Typical High $158.49 | Facility | None | $134.90 | $141.25 | $158.49 |
SummaCare Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $151.36 | Professional | None | $109.65 | $123.03 | $151.36 |
United Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $165.96 | Professional | None | $117.49 | $125.89 | $165.96 |
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 $21.38 Median $21.38 Typical High $22.39 | Professional | 52 · Reduced service | $21.38 | $21.38 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $9.12 | Professional | 53 · Discontinued | $8.51 | $8.51 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $31.62 Typical High $33.88 | Professional | 54 · Surgery only | $31.62 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.76 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.57 |
Where Ohio sits
The same service costs 6.3 times more in North Dakota than in Hawaii. 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· 48th of 51
$42.66
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.