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 $61.66 Median $114.82 Typical High $162.18 | Facility | None | $61.66 | $114.82 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $162.18 | Professional | None | $61.66 | $89.13 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $173.78 | Professional | None | $95.50 | $112.20 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $144.54 | Professional | None | $81.28 | $112.20 | $144.54 |
Aultcare Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $131.83 | Professional | None | $109.65 | $125.89 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $74.13 Median $120.23 Typical High $158.49 | Facility | None | $74.13 | $120.23 | $158.49 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $165.96 | Professional | None | $104.71 | $112.20 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $147.91 | Professional | None | $75.86 | $102.33 | $147.91 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $204.17 | Professional | None | $75.86 | $102.33 | $204.17 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $87.10 Typical High $151.36 | Professional | None | $43.65 | $87.10 | $151.36 |
SummaCare Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $117.49 | Professional | None | $70.79 | $89.13 | $117.49 |
United Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $134.90 | Professional | None | $63.10 | $89.13 | $134.90 |
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 $30.90 Median $43.65 Typical High $50.12 | Professional | 52 · Reduced service | $30.90 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $13.18 Typical High $14.79 | Professional | 55 · Aftercare only | $9.12 | $13.18 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.91 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.17 | $8.91 | $9.77 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $95.50 Median $112.20 Typical High $117.49 | Professional | 25 · Same-day visit | $95.50 | $112.20 | $117.49 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | GC · Resident with teaching physician | $93.33 | $93.33 | $93.33 |
Where Ohio sits
The same service costs 2.8 times more in Alaska than in Washington, DC. 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· 34th of 51
$102
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.