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 $67.61 Median $74.13 Typical High $309.03 | Facility | None | $67.61 | $74.13 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $234.42 | Professional | None | $67.61 | $74.13 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $177.83 | Professional | None | $89.13 | $93.33 | $177.83 |
Aultcare Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $91.20 Typical High $190.55 | Facility | None | $83.18 | $91.20 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $125.89 | Professional | None | $44.67 | $48.98 | $125.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $85.11 Median $91.20 Typical High $478.63 | Facility | None | $85.11 | $91.20 | $478.63 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $42.66 Median $48.98 Typical High $125.89 | Professional | None | $42.66 | $48.98 | $125.89 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $109.65 Typical High $162.18 | Professional | None | $53.70 | $109.65 | $162.18 |
SummaCare Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $144.54 | Professional | None | $75.86 | $100.00 | $144.54 |
United Setting Facility Modifier None Typical Low $346.74 Median $407.38 Typical High $575.44 | Facility | None | $346.74 | $407.38 | $575.44 |
United Setting Professional Modifier None Typical Low $54.95 Median $91.20 Typical High $141.25 | Professional | None | $54.95 | $91.20 | $141.25 |
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 $33.88 Median $37.15 Typical High $38.02 | Professional | 52 · Reduced service | $33.88 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.79 Typical High $15.14 | Professional | 53 · Discontinued | $13.49 | $14.79 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.96 Typical High $11.48 | Professional | 55 · Aftercare only | $10.23 | $10.96 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.41 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.76 | $7.41 | $7.59 |
Where Ohio sits
The same service costs 5.0 times more in Alaska than in Alabama. 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· 36th of 51
$91.20
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.