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 $199.53 Median $354.81 Typical High $588.84 | Facility | None | $199.53 | $354.81 | $588.84 |
Aetna Setting Professional Modifier None (both parts) Typical Low $199.53 Median $199.53 Typical High $537.03 | Professional | None (both parts) | $199.53 | $199.53 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $288.40 Typical High $457.09 | Facility | None | $199.53 | $288.40 | $457.09 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $39.81 Median $48.98 Typical High $309.03 | Professional | None (both parts) | $39.81 | $48.98 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $281.84 | Facility | None | $169.82 | $169.82 | $281.84 |
CareSource Setting Professional Modifier None (both parts) Typical Low $302.00 Median $3,890.45 Typical High $6,760.83 | Professional | None (both parts) | $302.00 | $3,890.45 | $6,760.83 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $288.40 Typical High $1,023.29 | Facility | None | $162.18 | $288.40 | $1,023.29 |
Cigna Setting Professional Modifier None (both parts) Typical Low $162.18 Median $302.00 Typical High $380.19 | Professional | None (both parts) | $162.18 | $302.00 | $380.19 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $162.18 Median $288.40 Typical High $1,023.29 | Facility | None | $162.18 | $288.40 | $1,023.29 |
Medical Mutual of Ohio Setting Professional Modifier None (both parts) Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None (both parts) | $162.18 | $162.18 | $162.18 |
Molina Setting Professional Modifier None (both parts) Typical Low $134.90 Median $134.90 Typical High $173.78 | Professional | None (both parts) | $134.90 | $134.90 | $173.78 |
SummaCare Setting Professional Modifier None (both parts) Typical Low $147.91 Median $208.93 Typical High $295.12 | Professional | None (both parts) | $147.91 | $208.93 | $295.12 |
United Setting Facility Modifier None Typical Low $89.13 Median $223.87 Typical High $371.54 | Facility | None | $89.13 | $223.87 | $371.54 |
United Setting Professional Modifier None (both parts) Typical Low $104.71 Median $147.91 Typical High $354.81 | Professional | None (both parts) | $104.71 | $147.91 | $354.81 |
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 Facility Modifier 52 · Reduced service Typical Low $97.72 Median $177.83 Typical High $295.12 | Facility | 52 · Reduced service | $97.72 | $177.83 | $295.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $39.81 Median $70.79 Typical High $117.49 | Facility | 53 · Discontinued | $39.81 | $70.79 | $117.49 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 26 · Professional part | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $97.72 Typical High $269.15 | Professional | 52 · Reduced service | $97.72 | $97.72 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $107.15 | Professional | 53 · Discontinued | $39.81 | $39.81 | $107.15 |
Where Ohio sits
The same service costs 12.0 times more in Wyoming than in Georgia. 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· 41st of 51
$166
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.