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 $51.29 Median $107.15 Typical High $208.93 | Facility | None | $51.29 | $107.15 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $64.57 Typical High $131.83 | Professional | None | $38.90 | $64.57 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $81.28 Typical High $81.28 | Professional | None | $53.70 | $81.28 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $794.33 Typical High $3,311.31 | Facility | None | $371.54 | $794.33 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $39.81 Typical High $66.07 | Professional | None | $36.31 | $39.81 | $66.07 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $45.71 Median $56.23 Typical High $93.33 | Professional | 50 · Both sides | $45.71 | $56.23 | $93.33 |
Aultcare Setting Professional Modifier None Typical Low $46.77 Median $75.86 Typical High $104.71 | Professional | None | $46.77 | $75.86 | $104.71 |
CareSource Setting Facility Modifier None Typical Low $48.98 Median $537.03 Typical High $812.83 | Facility | None | $48.98 | $537.03 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $97.72 | Professional | None | $63.10 | $79.43 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $794.33 | Facility | None | $50.12 | $66.07 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $61.66 Typical High $107.15 | Professional | None | $38.90 | $61.66 | $107.15 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $190.55 Typical High $724.44 | Facility | None | $58.88 | $190.55 | $724.44 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $38.90 Median $61.66 Typical High $104.71 | Professional | None | $38.90 | $61.66 | $104.71 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $102.33 | Professional | None | $50.12 | $67.61 | $102.33 |
SummaCare Setting Professional Modifier None Typical Low $40.74 Median $63.10 Typical High $91.20 | Professional | None | $40.74 | $63.10 | $91.20 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None Typical Low $29.51 Median $50.12 Typical High $97.72 | Professional | None | $29.51 | $50.12 | $97.72 |
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 $19.50 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $19.50 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $7.76 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $5.89 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.89 | $6.46 | $6.46 |
Where Ohio sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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· 42nd of 51
$61.66
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.