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 $741.31 Median $1,621.81 Typical High $2,398.83 | Facility | None | $741.31 | $1,621.81 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $2,511.89 | Professional | None | $602.56 | $630.96 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $891.25 Typical High $1,412.54 | Facility | None | $616.60 | $891.25 | $1,412.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $977.24 | Professional | None | $302.00 | $323.59 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $870.96 | Facility | None | $575.44 | $575.44 | $870.96 |
CareSource Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $891.25 Typical High $3,090.30 | Facility | None | $501.19 | $891.25 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $1,047.13 | Professional | None | $346.74 | $346.74 | $1,047.13 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $489.78 Median $912.01 Typical High $3,090.30 | Facility | None | $489.78 | $912.01 | $3,090.30 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $1,000.00 | Professional | None | $346.74 | $346.74 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $416.87 Median $630.96 Typical High $912.01 | Professional | None | $416.87 | $630.96 | $912.01 |
SummaCare Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $1,047.13 | Professional | None | $489.78 | $707.95 | $1,047.13 |
United Setting Facility Modifier None Typical Low $275.42 Median $676.08 Typical High $1,148.15 | Facility | None | $275.42 | $676.08 | $1,148.15 |
United Setting Professional Modifier None Typical Low $46.77 Median $380.19 Typical High $1,047.13 | Professional | None | $46.77 | $380.19 | $1,047.13 |
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 $302.00 Median $549.54 Typical High $912.01 | Facility | 52 · Reduced service | $302.00 | $549.54 | $912.01 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $120.23 Median $218.78 Typical High $363.08 | Facility | 53 · Discontinued | $120.23 | $218.78 | $363.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $302.00 Typical High $1,148.15 | Professional | 52 · Reduced service | $302.00 | $302.00 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $457.09 | Professional | 53 · Discontinued | $120.23 | $120.23 | $457.09 |
Where Ohio sits
The same service costs 4.5 times more in Alaska than in West Virginia. 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· 44th of 51
$525
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.