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 $25.70 Median $1,995.26 Typical High $10,964.78 | Facility | None | $25.70 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $57.54 Typical High $9,332.54 | Professional | None | $17.38 | $57.54 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $26.92 Typical High $39.81 | Professional | None | $19.50 | $26.92 | $39.81 |
CareSource Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $19.50 Typical High $52.48 | Professional | None | $18.20 | $19.50 | $52.48 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $21.38 Median $60.26 Typical High $147.91 | Facility | None | $21.38 | $60.26 | $147.91 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $18.20 Median $19.50 Typical High $52.48 | Professional | None | $18.20 | $19.50 | $52.48 |
SummaCare Setting Professional Modifier None Typical Low $18.62 Median $19.50 Typical High $35.48 | Professional | None | $18.62 | $19.50 | $35.48 |
United Setting Facility Modifier None Typical Low $95.50 Median $112.20 Typical High $158.49 | Facility | None | $95.50 | $112.20 | $158.49 |
United Setting Professional Modifier None Typical Low $19.05 Median $26.30 Typical High $50.12 | Professional | None | $19.05 | $26.30 | $50.12 |
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 $8.71 Median $8.71 Typical High $53.70 | Professional | 52 · Reduced service | $8.71 | $8.71 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.47 Typical High $21.38 | Professional | 53 · Discontinued | $3.47 | $3.47 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.57 Typical High $16.22 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $10.72 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $10.72 |
Where Ohio sits
The same service costs 40.7 times more in Tennessee than in New York. 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· 26th of 51
$28.18
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.