How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $16.98 Median $16.98 Typical High $85.11 | Facility | None | $16.98 | $16.98 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $19.95 | Professional | None | $16.98 | $16.98 | $19.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.22 Median $19.05 Typical High $27.54 | Professional | None | $16.22 | $19.05 | $27.54 |
CareSource Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $20.42 | Professional | None | $18.20 | $18.20 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $33.11 | Professional | None | $17.38 | $17.38 | $33.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $32.36 | Professional | None | $17.38 | $17.38 | $32.36 |
Molina Setting Professional Modifier None Typical Low $13.18 Median $15.49 Typical High $22.91 | Professional | None | $13.18 | $15.49 | $22.91 |
SummaCare Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $21.88 | Professional | None | $18.62 | $18.62 | $21.88 |
United Setting Professional Modifier None Typical Low $14.79 Median $18.20 Typical High $30.90 | Professional | None | $14.79 | $18.20 | $30.90 |
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 $8.51 Median $8.51 Typical High $10.23 | Professional | 52 · Reduced service | $8.51 | $8.51 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.39 Typical High $4.07 | Professional | 53 · Discontinued | $3.39 | $3.39 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.51 Typical High $3.02 | Professional | 55 · Aftercare only | $2.51 | $2.51 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.70 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.70 | $1.70 | $2.04 |
Where Ohio sits
The same service costs 3.4 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· 35th of 51
$18.62
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.