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 $75.86 Median $75.86 Typical High $194.98 | Facility | None | $75.86 | $75.86 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $138.04 | Professional | None | $75.86 | $75.86 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $120.23 Typical High $186.21 | Facility | None | $75.86 | $120.23 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $134.90 | Professional | None | $74.13 | $74.13 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $234.42 | Facility | None | $173.78 | $173.78 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | None | $81.28 | $81.28 | $87.10 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $234.42 | Facility | None | $173.78 | $173.78 | $234.42 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | None | $81.28 | $81.28 | $87.10 |
SummaCare Setting Professional Modifier None Typical Low $79.43 Median $83.18 Typical High $147.91 | Professional | None | $79.43 | $83.18 | $147.91 |
United Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $87.10 | Facility | None | $74.13 | $74.13 | $87.10 |
United Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $102.33 | Professional | None | $72.44 | $87.10 | $102.33 |
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 $37.15 Median $37.15 Typical High $63.10 | Professional | 52 · Reduced service | $37.15 | $37.15 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $25.12 | Professional | 53 · Discontinued | $15.14 | $15.14 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $19.05 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $12.59 |
Where Ohio sits
The same service costs 3.0 times more in Arizona than in Alabama. 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· 4th of 51
$87.10
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.