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 $50.12 | Professional | None | $10.00 | $18.20 | $50.12 |
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 $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $27.54 Median $35.48 Typical High $114.82 | Facility | None | $27.54 | $35.48 | $114.82 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
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 $25.12 | Professional | 52 · Reduced service | $5.01 | $5.01 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $10.00 | Professional | 53 · Discontinued | $2.00 | $2.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $7.59 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $5.01 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $5.01 |
Where Ohio sits
The same service costs 6.6 times more in Alabama than in Kansas. 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· 25th of 51
$23.99
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.