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 $25.12 Median $74.13 Typical High $89.13 | Facility | None | $25.12 | $74.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $29.51 Typical High $83.18 | Professional | None | $25.12 | $29.51 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $24.55 Median $39.81 Typical High $61.66 | Facility | None | $24.55 | $39.81 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $50.12 | Professional | None | $25.12 | $25.12 | $50.12 |
CareSource Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $79.43 | Facility | None | $58.88 | $58.88 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $29.51 | Professional | None | $27.54 | $27.54 | $29.51 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $79.43 | Facility | None | $58.88 | $58.88 | $79.43 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $29.51 | Professional | None | $27.54 | $27.54 | $29.51 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $34.67 Typical High $40.74 | Professional | None | $30.90 | $34.67 | $40.74 |
SummaCare Setting Professional Modifier None Typical Low $27.54 Median $28.84 Typical High $51.29 | Professional | None | $27.54 | $28.84 | $51.29 |
United Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $30.20 | Facility | None | $25.70 | $25.70 | $30.20 |
United Setting Professional Modifier None Typical Low $27.54 Median $29.51 Typical High $38.90 | Professional | None | $27.54 | $29.51 | $38.90 |
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 $12.30 Median $12.30 Typical High $32.36 | Professional | 52 · Reduced service | $12.30 | $12.30 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $12.88 | Professional | 53 · Discontinued | $5.01 | $5.01 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $9.55 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $6.46 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $6.46 |
Where Ohio sits
The same service costs 1.5 times more in Arizona than in Georgia. 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· 8th of 51
$31.62
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.