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 $93.33 Median $162.18 Typical High $257.04 | Facility | None | $93.33 | $162.18 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $208.93 | Professional | None | $75.86 | $100.00 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $64.57 Typical High $74.13 | Professional | None | $63.10 | $64.57 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $177.83 Typical High $489.78 | Facility | None | $81.28 | $177.83 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $158.49 | Professional | None | $75.86 | $85.11 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $199.53 Typical High $269.15 | Facility | None | $144.54 | $199.53 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $100.00 | Professional | None | $93.33 | $93.33 | $100.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $22.91 Median $154.88 Typical High $269.15 | Facility | None | $22.91 | $154.88 | $269.15 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $100.00 | Professional | None | $93.33 | $93.33 | $100.00 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $107.15 | Professional | None | $81.28 | $95.50 | $107.15 |
SummaCare Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $151.36 | Professional | None | $79.43 | $100.00 | $151.36 |
United Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $120.23 | Professional | None | $85.11 | $100.00 | $120.23 |
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 $38.02 Median $38.02 Typical High $72.44 | Professional | 52 · Reduced service | $38.02 | $38.02 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $28.84 | Professional | 53 · Discontinued | $15.14 | $15.14 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $21.88 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $14.45 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $14.45 |
Where Ohio sits
The same service costs 2.9 times more in Arizona 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· 9th of 51
$95.50
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.