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 $91.20 Median $245.47 Typical High $323.59 | Facility | None | $91.20 | $245.47 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $169.82 | Professional | None | $64.57 | $91.20 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $147.91 | Professional | None | $81.28 | $112.20 | $147.91 |
Aultcare Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $138.04 | Professional | None | $114.82 | $128.82 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $120.23 Typical High $158.49 | Facility | None | $77.62 | $120.23 | $158.49 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $173.78 | Professional | None | $107.15 | $117.49 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $151.36 | Professional | None | $79.43 | $107.15 | $151.36 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $213.80 | Professional | None | $79.43 | $107.15 | $213.80 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $79.43 Typical High $147.91 | Professional | None | $39.81 | $79.43 | $147.91 |
Optum Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $134.90 | Professional | None | $117.49 | $117.49 | $134.90 |
SummaCare Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $123.03 | Professional | None | $72.44 | $97.72 | $123.03 |
United Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $138.04 | Professional | None | $66.07 | $93.33 | $138.04 |
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 $32.36 Median $45.71 Typical High $52.48 | Professional | 52 · Reduced service | $32.36 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.80 Typical High $15.85 | Professional | 55 · Aftercare only | $9.77 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $9.12 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.46 | $9.12 | $10.47 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $100.00 Median $100.00 Typical High $131.83 | Professional | 25 · Same-day visit | $100.00 | $100.00 | $131.83 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $72.44 Median $72.44 Typical High $75.86 | Professional | GC · Resident with teaching physician | $72.44 | $72.44 | $75.86 |
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· 32nd of 51
$107
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.