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 $10.00 Median $33.88 Typical High $53.70 | Facility | None | $10.00 | $33.88 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $18.20 Typical High $53.70 | Professional | None | $10.00 | $18.20 | $53.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $23.99 Typical High $41.69 | Professional | None | $20.42 | $23.99 | $41.69 |
CareSource Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $26.30 Median $54.95 Typical High $97.72 | Facility | None | $26.30 | $54.95 | $97.72 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $16.22 Median $29.51 Typical High $29.51 | Professional | None | $16.22 | $29.51 | $29.51 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Professional Modifier None Typical Low $34.67 Median $36.31 Typical High $66.07 | Professional | None | $34.67 | $36.31 | $66.07 |
United Setting Facility Modifier None Typical Low $95.50 Median $112.20 Typical High $158.49 | Facility | None | $95.50 | $112.20 | $158.49 |
United Setting Professional Modifier None Typical Low $13.80 Median $23.99 Typical High $34.67 | Professional | None | $13.80 | $23.99 | $34.67 |
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 $5.01 Median $5.01 Typical High $25.70 | Professional | 52 · Reduced service | $5.01 | $5.01 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $10.47 | Professional | 53 · Discontinued | $2.00 | $2.00 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $7.76 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $5.25 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $5.25 |
Where Ohio sits
The same service costs 4.6 times more in Alabama than in Missouri. 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· 27th of 51
$25.70
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.