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 $524.81 Median $954.99 Typical High $1,584.89 | Facility | None | $524.81 | $954.99 | $1,584.89 |
Aetna Setting Professional Modifier None (both parts) Typical Low $524.81 Median $524.81 Typical High $1,445.44 | Professional | None (both parts) | $524.81 | $524.81 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $10.47 Median $13.18 Typical High $660.69 | Professional | None (both parts) | $10.47 | $13.18 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
CareSource Setting Professional Modifier None (both parts) Typical Low $812.83 Median $10,471.29 Typical High $18,197.01 | Professional | None (both parts) | $812.83 | $10,471.29 | $18,197.01 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $776.25 Typical High $1,445.44 | Facility | None | $645.65 | $776.25 | $1,445.44 |
Cigna Setting Professional Modifier None (both parts) Typical Low $426.58 Median $758.58 Typical High $954.99 | Professional | None (both parts) | $426.58 | $758.58 | $954.99 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $776.25 Typical High $3,715.35 | Facility | None | $426.58 | $776.25 | $3,715.35 |
Medical Mutual of Ohio Setting Professional Modifier None (both parts) Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None (both parts) | $426.58 | $426.58 | $426.58 |
Molina Setting Professional Modifier None (both parts) Typical Low $30.20 Median $363.08 Typical High $467.74 | Professional | None (both parts) | $30.20 | $363.08 | $467.74 |
SummaCare Setting Professional Modifier None (both parts) Typical Low $398.11 Median $562.34 Typical High $794.33 | Professional | None (both parts) | $398.11 | $562.34 | $794.33 |
United Setting Facility Modifier None Typical Low $239.88 Median $602.56 Typical High $1,000.00 | Facility | None | $239.88 | $602.56 | $1,000.00 |
United Setting Professional Modifier None (both parts) Typical Low $275.42 Median $398.11 Typical High $954.99 | Professional | None (both parts) | $275.42 | $398.11 | $954.99 |
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 $263.03 Median $478.63 Typical High $794.33 | Facility | 52 · Reduced service | $263.03 | $478.63 | $794.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $107.15 Median $190.55 Typical High $316.23 | Facility | 53 · Discontinued | $107.15 | $190.55 | $316.23 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 26 · Professional part | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $263.03 Typical High $707.95 | Professional | 52 · Reduced service | $263.03 | $263.03 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $288.40 | Professional | 53 · Discontinued | $107.15 | $107.15 | $288.40 |
Where Ohio sits
The same service costs 114.8 times more in Wisconsin than in Alabama. 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· 49th 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.