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 $83.18 Median $154.88 Typical High $281.84 | Facility | None | $83.18 | $154.88 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $181.97 | Professional | None | $81.28 | $81.28 | $181.97 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $58.88 Typical High $83.18 | Professional | None | $23.99 | $58.88 | $83.18 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $83.18 Typical High $107.15 | Professional | None | $79.43 | $83.18 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $154.88 | Professional | None | $74.13 | $89.13 | $154.88 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $114.82 Median $213.80 Typical High $338.84 | Facility | None | $114.82 | $213.80 | $338.84 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $117.49 | Professional | None | $67.61 | $79.43 | $117.49 |
Molina Setting Professional Modifier None Typical Low $52.48 Median $66.07 Typical High $100.00 | Professional | None | $52.48 | $66.07 | $100.00 |
SummaCare Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $100.00 | Professional | None | $69.18 | $85.11 | $100.00 |
United Setting Facility Modifier None Typical Low $67.61 Median $75.86 Typical High $93.33 | Facility | None | $67.61 | $75.86 | $93.33 |
United Setting Professional Modifier None Typical Low $23.99 Median $74.13 Typical High $151.36 | Professional | None | $23.99 | $74.13 | $151.36 |
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 $40.74 Median $40.74 Typical High $89.13 | Professional | 52 · Reduced service | $40.74 | $40.74 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $35.48 | Professional | 53 · Discontinued | $16.22 | $16.22 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $26.92 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $17.78 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $17.78 |
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | GN · Speech therapy plan | $91.20 | $91.20 | $91.20 |
Where Ohio sits
The same service costs 2.9 times more in Alaska than in Utah. 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· 46th of 51
$69.18
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.