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 $4,677.35 Median $9,772.37 Typical High $13,489.63 | Facility | None | $4,677.35 | $9,772.37 | $13,489.63 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $1,995.26 Median $3,715.35 Typical High $6,025.60 | Facility | 52 · Reduced service | $1,995.26 | $3,715.35 | $6,025.60 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $794.33 Median $1,479.11 Typical High $2,398.83 | Facility | 53 · Discontinued | $794.33 | $1,479.11 | $2,398.83 |
Aetna Setting Professional Modifier None (both parts) Typical Low $3,981.07 Median $3,981.07 Typical High $9,772.37 | Professional | None (both parts) | $3,981.07 | $3,981.07 | $9,772.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,995.26 Median $1,995.26 Typical High $4,897.79 | Professional | 52 · Reduced service | $1,995.26 | $1,995.26 | $4,897.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $794.33 Typical High $1,949.84 | Professional | 53 · Discontinued | $794.33 | $794.33 | $1,949.84 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $1,905.46 Median $1,995.26 Typical High $5,370.32 | Professional | None (both parts) | $1,905.46 | $1,995.26 | $5,370.32 |
CareSource Setting Facility Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Facility | None | $4,570.88 | $4,570.88 | $4,570.88 |
CareSource Setting Professional Modifier None (both parts) Typical Low $6,165.95 Median $77,624.71 Typical High $138,038.43 | Professional | None (both parts) | $6,165.95 | $77,624.71 | $138,038.43 |
Cigna Setting Facility Modifier None Typical Low $4,897.79 Median $5,888.44 Typical High $25,118.86 | Facility | None | $4,897.79 | $5,888.44 | $25,118.86 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5,370.32 Median $5,888.44 Typical High $27,542.29 | Facility | None | $5,370.32 | $5,888.44 | $27,542.29 |
Molina Setting Professional Modifier None (both parts) Typical Low $30.20 Median $50.12 Typical High $4,168.69 | Professional | None (both parts) | $30.20 | $50.12 | $4,168.69 |
SummaCare Setting Professional Modifier None (both parts) Typical Low $4,265.80 Median $6,165.95 Typical High $7,079.46 | Professional | None (both parts) | $4,265.80 | $6,165.95 | $7,079.46 |
United Setting Professional Modifier None (both parts) Typical Low $2,089.30 Median $3,019.95 Typical High $7,079.46 | Professional | None (both parts) | $2,089.30 | $3,019.95 | $7,079.46 |
2 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 26 · Professional part Typical Low $3,981.07 Median $10,964.78 Typical High $13,489.63 | Facility | 26 · Professional part | $3,981.07 | $10,964.78 | $13,489.63 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | 26 · Professional part | $3,981.07 | $3,981.07 | $3,981.07 |
Where Ohio sits
The same service costs 12.0 times more in Texas 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
$2,818
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.