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 $17.38 Median $31.62 Typical High $56.23 | Facility | None | $17.38 | $31.62 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $19.05 Typical High $45.71 | Professional | None | $10.00 | $19.05 | $45.71 |
Ambetter Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $10,715.19 Typical High $18,620.87 | Facility | None | $3,630.78 | $10,715.19 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.32 Median $17.38 Typical High $26.92 | Professional | None | $8.32 | $17.38 | $26.92 |
CareSource Setting Facility Modifier None Typical Low $11.22 Median $537.03 Typical High $812.83 | Facility | None | $11.22 | $537.03 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $19.95 Median $20.89 Typical High $22.39 | Professional | None | $19.95 | $20.89 | $22.39 |
Cigna Setting Facility Modifier None Typical Low $8.51 Median $10.00 Typical High $33.11 | Facility | None | $8.51 | $10.00 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $17.38 Typical High $32.36 | Professional | None | $9.55 | $17.38 | $32.36 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $9.33 Median $11.48 Typical High $104.71 | Facility | None | $9.33 | $11.48 | $104.71 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $9.55 Median $17.38 Typical High $33.11 | Professional | None | $9.55 | $17.38 | $33.11 |
Molina Setting Professional Modifier None Typical Low $7.08 Median $8.32 Typical High $16.22 | Professional | None | $7.08 | $8.32 | $16.22 |
SummaCare Setting Professional Modifier None Typical Low $8.32 Median $19.05 Typical High $25.12 | Professional | None | $8.32 | $19.05 | $25.12 |
United Setting Professional Modifier None Typical Low $10.00 Median $18.20 Typical High $36.31 | Professional | None | $10.00 | $18.20 | $36.31 |
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 $5.01 Median $9.55 Typical High $11.22 | Professional | 52 · Reduced service | $5.01 | $9.55 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $3.80 Typical High $4.47 | Professional | 53 · Discontinued | $2.00 | $3.80 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $2.82 Typical High $3.39 | Professional | 55 · Aftercare only | $1.51 | $2.82 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.91 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.00 | $1.91 | $2.24 |
Where Ohio sits
The same service costs 3.1 times more in Wisconsin than in Louisiana. 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· 39th of 51
$17.38
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.