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 $29.51 Median $61.66 Typical High $102.33 | Facility | None | $29.51 | $61.66 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $29.51 Typical High $53.70 | Professional | None | $18.62 | $29.51 | $53.70 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | None | $32.36 | $32.36 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $31.62 Typical High $41.69 | Professional | None | $19.50 | $31.62 | $41.69 |
Aultcare Setting Professional Modifier None Typical Low $35.48 Median $41.69 Typical High $48.98 | Professional | None | $35.48 | $41.69 | $48.98 |
CareSource Setting Professional Modifier None Typical Low $34.67 Median $37.15 Typical High $54.95 | Professional | None | $34.67 | $37.15 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $35.48 Typical High $48.98 | Professional | None | $22.91 | $35.48 | $48.98 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $15.14 Median $33.11 Typical High $56.23 | Professional | None | $15.14 | $33.11 | $56.23 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $30.20 Typical High $45.71 | Professional | None | $20.42 | $30.20 | $45.71 |
SummaCare Setting Professional Modifier None Typical Low $21.38 Median $32.36 Typical High $39.81 | Professional | None | $21.38 | $32.36 | $39.81 |
United Setting Professional Modifier None Typical Low $20.42 Median $30.20 Typical High $43.65 | Professional | None | $20.42 | $30.20 | $43.65 |
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 $9.12 Median $14.79 Typical High $16.60 | Professional | 52 · Reduced service | $9.12 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $4.47 Typical High $5.01 | Professional | 55 · Aftercare only | $2.75 | $4.47 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $2.95 Typical High $3.39 | Professional | 56 · Pre-op care only | $1.82 | $2.95 | $3.39 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $20.42 Median $37.15 Typical High $38.02 | Professional | 25 · Same-day visit | $20.42 | $37.15 | $38.02 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | SA · Nurse practitioner | $32.36 | $32.36 | $32.36 |
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· 40th of 51
$30.90
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.