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 $69.18 Median $199.53 Typical High $245.47 | Facility | None | $69.18 | $199.53 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $134.90 | Professional | None | $69.18 | $69.18 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $47.86 Median $60.26 Typical High $60.26 | Professional | None | $47.86 | $60.26 | $60.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $100.00 | Professional | None | $56.23 | $66.07 | $100.00 |
Aultcare Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
CareSource Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $104.71 | Professional | None | $66.07 | $74.13 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $70.79 Typical High $120.23 | Professional | None | $66.07 | $70.79 | $120.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $63.10 Median $70.79 Typical High $107.15 | Professional | None | $63.10 | $70.79 | $107.15 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $41.69 Typical High $58.88 | Professional | None | $28.84 | $41.69 | $58.88 |
SummaCare Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $100.00 | Professional | None | $63.10 | $63.10 | $100.00 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,344.23 | Facility | None | $1,412.54 | $1,659.59 | $2,344.23 |
United Setting Professional Modifier None Typical Low $57.54 Median $66.07 Typical High $117.49 | Professional | None | $57.54 | $66.07 | $117.49 |
5 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 $33.88 Median $33.88 Typical High $39.81 | Professional | 52 · Reduced service | $33.88 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $15.85 | Professional | 53 · Discontinued | $13.80 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $11.75 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $7.94 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | GC · Resident with teaching physician | $63.10 | $63.10 | $63.10 |
Where Ohio sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 49th of 51
$66.07
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.