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 $42.66 Median $83.18 Typical High $181.97 | Facility | None | $42.66 | $83.18 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $83.18 Typical High $85.11 | Professional | None | $42.66 | $83.18 | $85.11 |
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 $33.88 Median $41.69 Typical High $64.57 | Professional | None | $33.88 | $41.69 | $64.57 |
CareSource Setting Facility Modifier None Typical Low $53.70 Median $58.88 Typical High $75.86 | Facility | None | $53.70 | $58.88 | $75.86 |
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 $44.67 Median $81.28 Typical High $134.90 | Professional | None | $44.67 | $81.28 | $134.90 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $77.62 Typical High $151.36 | Facility | None | $58.88 | $77.62 | $151.36 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $44.67 Median $81.28 Typical High $134.90 | Professional | None | $44.67 | $81.28 | $134.90 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $158.49 | Professional | None | $79.43 | $104.71 | $158.49 |
SummaCare Setting Facility Modifier None Typical Low $37.15 Median $38.90 Typical High $43.65 | Facility | None | $37.15 | $38.90 | $43.65 |
SummaCare Setting Professional Modifier None Typical Low $39.81 Median $77.62 Typical High $112.20 | Professional | None | $39.81 | $77.62 | $112.20 |
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 $33.11 Median $60.26 Typical High $117.49 | Professional | None | $33.11 | $60.26 | $117.49 |
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 $21.38 Median $41.69 Typical High $42.66 | Professional | 52 · Reduced service | $21.38 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $16.60 Typical High $16.98 | Professional | 53 · Discontinued | $8.51 | $16.60 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $12.30 Typical High $12.88 | Professional | 55 · Aftercare only | $6.31 | $12.30 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $8.32 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.27 | $8.32 | $8.51 |
Where Ohio sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 35th of 51
$77.62
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.