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 $10.00 Median $27.54 Typical High $53.70 | Facility | None | $10.00 | $27.54 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $15.85 Typical High $43.65 | Professional | None | $10.00 | $15.85 | $43.65 |
Ambetter Setting Professional Modifier None Typical Low $15.14 Median $20.89 Typical High $24.55 | Professional | None | $15.14 | $20.89 | $24.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $23.99 Typical High $38.02 | Professional | None | $20.42 | $23.99 | $38.02 |
CareSource Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
CareSource Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $20.42 Typical High $48.98 | Professional | None | $12.02 | $20.42 | $48.98 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $19.50 Median $45.71 Typical High $93.33 | Facility | None | $19.50 | $45.71 | $93.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $12.02 Median $18.62 Typical High $36.31 | Professional | None | $12.02 | $18.62 | $36.31 |
SummaCare Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
SummaCare Setting Professional Modifier None Typical Low $22.91 Median $33.88 Typical High $39.81 | Professional | None | $22.91 | $33.88 | $39.81 |
United Setting Facility Modifier None Typical Low $147.91 Median $173.78 Typical High $245.47 | Facility | None | $147.91 | $173.78 | $245.47 |
United Setting Professional Modifier None Typical Low $13.80 Median $21.38 Typical High $33.88 | Professional | None | $13.80 | $21.38 | $33.88 |
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 $5.01 Typical High $23.99 | Professional | 52 · Reduced service | $5.01 | $5.01 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $9.55 | Professional | 53 · Discontinued | $2.00 | $2.00 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $7.24 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $4.79 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $4.79 |
Where Ohio sits
The same service costs 5.4 times more in Vermont than in Kansas. 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· 30th of 51
$23.99
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.