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 $51.29 Median $93.33 Typical High $169.82 | Facility | None | $51.29 | $93.33 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $58.88 Typical High $141.25 | Professional | None | $51.29 | $58.88 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $45.71 | Professional | None | $38.90 | $38.90 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $112.20 Typical High $309.03 | Facility | None | $51.29 | $112.20 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $48.98 Typical High $91.20 | Professional | None | $41.69 | $48.98 | $91.20 |
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 $114.82 Median $114.82 Typical High $154.88 | Facility | None | $114.82 | $114.82 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $57.54 | Professional | None | $53.70 | $53.70 | $57.54 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $19.05 Median $114.82 Typical High $154.88 | Facility | None | $19.05 | $114.82 | $154.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $57.54 | Professional | None | $53.70 | $53.70 | $57.54 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Professional Modifier None Typical Low $53.70 Median $54.95 Typical High $100.00 | Professional | None | $53.70 | $54.95 | $100.00 |
United Setting Professional Modifier None Typical Low $46.77 Median $57.54 Typical High $64.57 | Professional | None | $46.77 | $57.54 | $64.57 |
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 $25.70 Median $25.70 Typical High $38.02 | Professional | 52 · Reduced service | $25.70 | $25.70 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $15.14 | Professional | 53 · Discontinued | $10.23 | $10.23 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $11.48 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $7.59 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $7.59 |
Where Ohio sits
The same service costs 1.5 times more in Colorado than in Alaska. 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· 16th of 51
$53.70
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.