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 $0.02 Median $5,248.07 Typical High $13,803.84 | Facility | None | $0.02 | $5,248.07 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $6,025.60 Median $9,332.54 Typical High $12,589.25 | Professional | None | $6,025.60 | $9,332.54 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $6,309.57 | Professional | None | $851.14 | $851.14 | $6,309.57 |
CareSource Setting Professional Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $6,760.83 | Professional | None | $6,760.83 | $6,760.83 | $6,760.83 |
Cigna Setting Facility Modifier None Typical Low $4,897.79 Median $6,025.60 Typical High $20,417.38 | Facility | None | $4,897.79 | $6,025.60 | $20,417.38 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $9,120.11 | Professional | None | $2,290.87 | $2,290.87 | $9,120.11 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5,370.32 Median $6,309.57 Typical High $20,417.38 | Facility | None | $5,370.32 | $6,309.57 | $20,417.38 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $9,120.11 | Professional | None | $2,290.87 | $2,290.87 | $9,120.11 |
Molina Setting Professional Modifier None Typical Low $3,467.37 Median $4,570.88 Typical High $6,165.95 | Professional | None | $3,467.37 | $4,570.88 | $6,165.95 |
SummaCare Setting Professional Modifier None Typical Low $4,265.80 Median $6,165.95 Typical High $7,943.28 | Professional | None | $4,265.80 | $6,165.95 | $7,943.28 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $4,570.88 Typical High $7,585.78 | Facility | None | $1,819.70 | $4,570.88 | $7,585.78 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $3,019.95 Typical High $7,244.36 | Professional | None | $2,089.30 | $3,019.95 | $7,244.36 |
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 Facility Modifier 52 · Reduced service Typical Low $0.02 Median $4,677.35 Typical High $6,309.57 | Facility | 52 · Reduced service | $0.02 | $4,677.35 | $6,309.57 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1,047.13 Median $1,862.09 Typical High $2,511.89 | Facility | 53 · Discontinued | $1,047.13 | $1,862.09 | $2,511.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3,019.95 Median $4,677.35 Typical High $6,309.57 | Professional | 52 · Reduced service | $3,019.95 | $4,677.35 | $6,309.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,202.26 Median $1,862.09 Typical High $2,511.89 | Professional | 53 · Discontinued | $1,202.26 | $1,862.09 | $2,511.89 |
Where Ohio sits
The same service costs 30.9 times more in Texas 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· 49th of 51
$2,089
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.