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 $181.97 Median $316.23 Typical High $478.63 | Facility | None | $181.97 | $316.23 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $389.05 | Professional | None | $109.65 | $141.25 | $389.05 |
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 $95.50 Median $120.23 Typical High $186.21 | Professional | None | $95.50 | $120.23 | $186.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $144.54 Median $181.97 Typical High $269.15 | Professional | 50 · Both sides | $144.54 | $181.97 | $269.15 |
Aultcare Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $87.10 Typical High $138.04 | Facility | None | $66.07 | $87.10 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $77.62 Typical High $151.36 | Facility | None | $58.88 | $77.62 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $234.42 | Professional | None | $114.82 | $144.54 | $234.42 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $77.62 Typical High $165.96 | Facility | None | $58.88 | $77.62 | $165.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $263.03 | Professional | None | $114.82 | $151.36 | $263.03 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $208.93 | Professional | None | $109.65 | $138.04 | $208.93 |
SummaCare Setting Facility Modifier None Typical Low $36.31 Median $38.02 Typical High $43.65 | Facility | None | $36.31 | $38.02 | $43.65 |
SummaCare Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $169.82 | Professional | None | $102.33 | $134.90 | $169.82 |
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 $85.11 Median $138.04 Typical High $234.42 | Professional | None | $85.11 | $138.04 | $234.42 |
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 $54.95 Median $70.79 Typical High $74.13 | Professional | 52 · Reduced service | $54.95 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $28.18 Typical High $29.51 | Professional | 53 · Discontinued | $21.88 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $20.89 Typical High $21.88 | Professional | 55 · Aftercare only | $16.22 | $20.89 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $14.13 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.96 | $14.13 | $14.79 |
Where Ohio sits
The same service costs 4.3 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· 38th of 51
$141
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.