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 $125.89 Median $346.74 Typical High $446.68 | Facility | None | $125.89 | $346.74 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $229.09 | Professional | None | $95.50 | $125.89 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $186.21 | Professional | None | $109.65 | $138.04 | $186.21 |
Aultcare Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $323.59 | Professional | None | $177.83 | $177.83 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $173.78 Typical High $223.87 | Facility | None | $114.82 | $173.78 | $223.87 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | None | $125.89 | $125.89 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $208.93 | Professional | None | $117.49 | $147.91 | $208.93 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $302.00 | Professional | None | $112.20 | $147.91 | $302.00 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $114.82 Typical High $190.55 | Professional | None | $63.10 | $114.82 | $190.55 |
SummaCare Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $199.53 | Professional | None | $109.65 | $138.04 | $199.53 |
United Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $199.53 | Professional | None | $95.50 | $128.82 | $199.53 |
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 $47.86 Median $63.10 Typical High $72.44 | Professional | 52 · Reduced service | $47.86 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $18.62 Typical High $21.88 | Professional | 55 · Aftercare only | $14.45 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.59 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.55 | $12.59 | $14.45 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $138.04 Median $173.78 Typical High $223.87 | Professional | 25 · Same-day visit | $138.04 | $173.78 | $223.87 |
Where Ohio sits
The same service costs 2.6 times more in Alaska than in Florida. 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· 36th of 51
$138
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.