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 $32.36 Median $89.13 Typical High $109.65 | Facility | None | $32.36 | $89.13 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $35.48 Typical High $75.86 | Professional | None | $32.36 | $35.48 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $33.88 Median $74.13 Typical High $204.17 | Facility | None | $33.88 | $74.13 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $32.36 Typical High $58.88 | Professional | None | $30.20 | $32.36 | $58.88 |
CareSource Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
CareSource Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $102.33 | Facility | None | $75.86 | $75.86 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $38.02 | Professional | None | $35.48 | $35.48 | $38.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $18.20 Median $75.86 Typical High $102.33 | Facility | None | $18.20 | $75.86 | $102.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $38.02 | Professional | None | $35.48 | $35.48 | $38.02 |
Molina Setting Professional Modifier None Typical Low $40.74 Median $48.98 Typical High $69.18 | Professional | None | $40.74 | $48.98 | $69.18 |
SummaCare Setting Professional Modifier None Typical Low $36.31 Median $38.02 Typical High $72.44 | Professional | None | $36.31 | $38.02 | $72.44 |
United Setting Professional Modifier None Typical Low $30.90 Median $38.02 Typical High $43.65 | Professional | None | $30.90 | $38.02 | $43.65 |
5 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 $16.22 Median $16.22 Typical High $42.66 | Professional | 52 · Reduced service | $16.22 | $16.22 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $17.38 | Professional | 53 · Discontinued | $6.46 | $6.46 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $12.88 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $8.51 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $8.51 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | JZ · No drug discarded | $25.70 | $25.70 | $30.20 |
Where Ohio sits
The same service costs 97.7 times more in Arizona than in Rhode Island. 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· 31st of 51
$35.48
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.