How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $56.23 Median $67.61 Typical High $199.53 | Facility | None | $56.23 | $67.61 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $67.61 Typical High $102.33 | Professional | None | $56.23 | $67.61 | $102.33 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $85.11 | Professional | None | $72.44 | $85.11 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $107.15 | Professional | None | $60.26 | $77.62 | $107.15 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $83.18 | Professional | None | $74.13 | $74.13 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $120.23 | Professional | None | $67.61 | $79.43 | $120.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $112.20 | Professional | None | $67.61 | $79.43 | $112.20 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $97.72 | Professional | None | $42.66 | $64.57 | $97.72 |
SummaCare Setting Professional Modifier None Typical Low $64.57 Median $75.86 Typical High $104.71 | Professional | None | $64.57 | $75.86 | $104.71 |
United Setting Professional Modifier None Typical Low $61.66 Median $77.62 Typical High $114.82 | Professional | None | $61.66 | $77.62 | $114.82 |
3 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 $28.18 Median $33.11 Typical High $38.90 | Professional | 52 · Reduced service | $28.18 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.00 Typical High $11.75 | Professional | 55 · Aftercare only | $8.32 | $10.00 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.62 | $6.76 | $7.76 |
Where Ohio sits
The same service costs 2.9 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· 41st of 51
$75.86
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.