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 $19.50 Median $19.50 Typical High $54.95 | Facility | None | $19.50 | $19.50 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $54.95 | Professional | None | $19.50 | $19.50 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.03 Typical High $0.07 | Facility | None | $0.02 | $0.03 | $0.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $31.62 | Professional | None | $19.50 | $19.50 | $31.62 |
CareSource Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $61.66 | Facility | None | $45.71 | $45.71 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $22.91 | Professional | None | $21.38 | $21.38 | $22.91 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $61.66 | Facility | None | $45.71 | $45.71 | $61.66 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $22.91 | Professional | None | $21.38 | $21.38 | $22.91 |
Molina Setting Professional Modifier None Typical Low $23.99 Median $26.92 Typical High $31.62 | Professional | None | $23.99 | $26.92 | $31.62 |
United Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $16.60 | Facility | None | $14.13 | $14.13 | $16.60 |
United Setting Professional Modifier None Typical Low $22.91 Median $25.70 Typical High $32.36 | Professional | None | $22.91 | $25.70 | $32.36 |
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 $9.77 Median $9.77 Typical High $27.54 | Professional | 52 · Reduced service | $9.77 | $9.77 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $10.96 | Professional | 53 · Discontinued | $3.89 | $3.89 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $2.88 Typical High $8.32 | Professional | 55 · Aftercare only | $2.88 | $2.88 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $5.50 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $5.50 |
Where Ohio sits
The same service costs 2.0 times more in Alabama than in Connecticut. 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· 38th of 51
$21.38
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.