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 $16.98 Median $20.42 Typical High $56.23 | Facility | None | $16.98 | $20.42 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $20.42 Typical High $53.70 | Professional | None | $16.98 | $20.42 | $53.70 |
Ambetter Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.88 Median $25.70 Typical High $46.77 | Professional | None | $21.88 | $25.70 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $20.42 Median $22.39 Typical High $46.77 | Facility | None | $20.42 | $22.39 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $13.49 Typical High $34.67 | Professional | None | $10.96 | $13.49 | $34.67 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $21.38 Median $22.39 Typical High $117.49 | Facility | None | $21.38 | $22.39 | $117.49 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $10.47 Median $12.88 Typical High $35.48 | Professional | None | $10.47 | $12.88 | $35.48 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $18.62 Typical High $21.88 | Professional | None | $14.79 | $18.62 | $21.88 |
SummaCare Setting Professional Modifier None Typical Low $19.05 Median $26.92 Typical High $39.81 | Professional | None | $19.05 | $26.92 | $39.81 |
United Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $177.83 | Facility | None | $107.15 | $125.89 | $177.83 |
United Setting Professional Modifier None Typical Low $14.13 Median $23.44 Typical High $38.90 | Professional | None | $14.13 | $23.44 | $38.90 |
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 $8.51 Median $10.23 Typical High $10.47 | Professional | 52 · Reduced service | $8.51 | $10.23 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $4.07 Typical High $4.17 | Professional | 53 · Discontinued | $3.39 | $4.07 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $2.51 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $2.04 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.70 | $2.04 | $2.09 |
Where Ohio sits
The same service costs 4.5 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
$21.88
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.