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 $22.39 Median $48.98 Typical High $63.10 | Facility | None | $22.39 | $48.98 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $24.55 Typical High $58.88 | Professional | None | $18.62 | $24.55 | $58.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $18.62 Median $29.51 Typical High $45.71 | Facility | None | $18.62 | $29.51 | $45.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.05 Median $19.95 Typical High $38.02 | Professional | None | $19.05 | $19.95 | $38.02 |
CareSource Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $60.26 | Facility | None | $44.67 | $44.67 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $21.88 | Professional | None | $20.42 | $20.42 | $21.88 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $60.26 | Facility | None | $44.67 | $44.67 | $60.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $21.88 | Professional | None | $20.42 | $20.42 | $21.88 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $30.20 Typical High $41.69 | Professional | None | $26.30 | $30.20 | $41.69 |
SummaCare Setting Professional Modifier None Typical Low $20.42 Median $21.38 Typical High $38.90 | Professional | None | $20.42 | $21.38 | $38.90 |
United Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $22.91 | Facility | None | $19.50 | $19.50 | $22.91 |
United Setting Professional Modifier None Typical Low $20.89 Median $21.88 Typical High $29.51 | Professional | None | $20.89 | $21.88 | $29.51 |
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 $9.33 Median $9.33 Typical High $22.39 | Professional | 52 · Reduced service | $9.33 | $9.33 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $8.91 | Professional | 53 · Discontinued | $3.72 | $3.72 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $6.76 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $4.47 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $4.47 |
Where Ohio sits
The same service costs 2.1 times more in Alabama 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· 5th of 51
$24.55
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.