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 $28.84 Median $28.84 Typical High $57.54 | Facility | None | $28.84 | $28.84 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $57.54 | Professional | None | $28.84 | $28.84 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.84 Median $45.71 Typical High $70.79 | Facility | None | $28.84 | $45.71 | $70.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $28.84 Typical High $51.29 | Professional | None | $24.55 | $28.84 | $51.29 |
CareSource Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $93.33 | Facility | None | $69.18 | $69.18 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $33.88 | Professional | None | $31.62 | $31.62 | $33.88 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $93.33 | Facility | None | $69.18 | $69.18 | $93.33 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $34.67 | Professional | None | $31.62 | $31.62 | $34.67 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $40.74 Typical High $46.77 | Professional | None | $35.48 | $40.74 | $46.77 |
SummaCare Setting Professional Modifier None Typical Low $31.62 Median $33.11 Typical High $60.26 | Professional | None | $31.62 | $33.11 | $60.26 |
United Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $33.88 | Facility | None | $28.84 | $28.84 | $33.88 |
United Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $45.71 | Professional | None | $32.36 | $33.88 | $45.71 |
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 $14.45 Median $14.45 Typical High $28.18 | Professional | 52 · Reduced service | $14.45 | $14.45 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $11.48 | Professional | 53 · Discontinued | $5.75 | $5.75 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $8.51 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $5.75 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $5.75 |
Where Ohio sits
The same service costs 1.6 times more in Arizona than in Georgia. 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· 13th of 51
$33.88
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.