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 $91.20 Median $181.97 Typical High $251.19 | Facility | None | $91.20 | $181.97 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $223.87 | Professional | None | $75.86 | $102.33 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $91.20 | Professional | None | $75.86 | $75.86 | $91.20 |
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 $63.10 Median $74.13 Typical High $141.25 | Professional | None | $63.10 | $74.13 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
CareSource Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
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 $31.62 Median $173.78 Typical High $234.42 | Facility | None | $31.62 | $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 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $109.65 | Professional | None | $83.18 | $93.33 | $109.65 |
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 $75.86 Median $75.86 Typical High $89.13 | Facility | None | $75.86 | $75.86 | $89.13 |
United Setting Professional Modifier None Typical Low $72.44 Median $89.13 Typical High $102.33 | Professional | None | $72.44 | $89.13 | $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 $72.44 | Professional | 52 · Reduced service | $37.15 | $37.15 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $28.84 | Professional | 53 · Discontinued | $15.14 | $15.14 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $21.38 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $14.45 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $14.45 |
Where Ohio sits
The same service costs 2.8 times more in Alaska 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
$93.33
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.