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 $22.91 Median $56.23 Typical High $165.96 | Facility | None | $22.91 | $56.23 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $56.23 Typical High $158.49 | Professional | None | $22.91 | $56.23 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.91 Median $23.44 Typical High $35.48 | Professional | None | $22.91 | $23.44 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $60.26 Typical High $107.15 | Professional | None | $22.91 | $60.26 | $107.15 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $22.91 Median $60.26 Typical High $104.71 | Professional | None | $22.91 | $60.26 | $104.71 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $79.43 Typical High $109.65 | Professional | None | $53.70 | $79.43 | $109.65 |
SummaCare Setting Professional Modifier None Typical Low $21.88 Median $47.86 Typical High $75.86 | Professional | None | $21.88 | $47.86 | $75.86 |
United Setting Professional Modifier None Typical Low $21.38 Median $54.95 Typical High $112.20 | Professional | None | $21.38 | $54.95 | $112.20 |
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 $11.48 Median $28.18 Typical High $33.11 | Professional | 52 · Reduced service | $11.48 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $11.48 Typical High $13.18 | Professional | 53 · Discontinued | $4.68 | $11.48 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $8.51 Typical High $9.77 | Professional | 55 · Aftercare only | $3.47 | $8.51 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $5.62 Typical High $6.61 | Professional | 56 · Pre-op care only | $2.29 | $5.62 | $6.61 |
Where Ohio sits
The same service costs 4.4 times more in North Dakota than in Kentucky. 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· 28th of 51
$56.23
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.