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 $19.95 Median $19.95 Typical High $79.43 | Facility | None | $19.95 | $19.95 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $21.38 | Professional | None | $19.95 | $19.95 | $21.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.78 Median $20.89 Typical High $29.51 | Professional | None | $17.78 | $20.89 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $61.66 | Facility | None | $45.71 | $45.71 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | None | $21.38 | $21.38 | $25.12 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $61.66 | Facility | None | $45.71 | $45.71 | $61.66 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | None | $21.38 | $21.38 | $25.12 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
United Setting Professional Modifier None Typical Low $19.95 Median $21.38 Typical High $25.12 | Professional | None | $19.95 | $21.38 | $25.12 |
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 $10.00 Median $10.00 Typical High $10.72 | Professional | 52 · Reduced service | $10.00 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $4.27 | Professional | 53 · Discontinued | $3.98 | $3.98 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $3.16 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.00 Typical High $2.14 | Professional | 56 · Pre-op care only | $2.00 | $2.00 | $2.14 |
Where Ohio sits
The same service costs 1.7 times more in Alaska 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· 30th of 51
$21.38
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.