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 $43.65 Median $63.10 Typical High $169.82 | Facility | None | $43.65 | $63.10 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $63.10 | Professional | None | $39.81 | $52.48 | $63.10 |
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 $43.65 Typical High $70.79 | Professional | None | $36.31 | $43.65 | $70.79 |
CareSource Setting Facility Modifier None Typical Low $34.67 Median $44.67 Typical High $54.95 | Facility | None | $34.67 | $44.67 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $50.12 Typical High $100.00 | Facility | None | $37.15 | $50.12 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $102.33 | Professional | None | $43.65 | $60.26 | $102.33 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $37.15 Median $50.12 Typical High $100.00 | Facility | None | $37.15 | $50.12 | $100.00 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $102.33 | Professional | None | $43.65 | $60.26 | $102.33 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $104.71 | Professional | None | $53.70 | $69.18 | $104.71 |
SummaCare Setting Facility Modifier None Typical Low $19.95 Median $20.89 Typical High $23.99 | Facility | None | $19.95 | $20.89 | $23.99 |
SummaCare Setting Professional Modifier None Typical Low $39.81 Median $53.70 Typical High $77.62 | Professional | None | $39.81 | $53.70 | $77.62 |
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 $33.88 Median $53.70 Typical High $97.72 | Professional | None | $33.88 | $53.70 | $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 $21.88 Median $31.62 Typical High $33.11 | Professional | 52 · Reduced service | $21.88 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $12.59 Typical High $13.18 | Professional | 53 · Discontinued | $8.71 | $12.59 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $9.33 Typical High $9.77 | Professional | 55 · Aftercare only | $6.46 | $9.33 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.31 Typical High $6.61 | Professional | 56 · Pre-op care only | $4.37 | $6.31 | $6.61 |
Where Ohio sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$60.26
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.