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 $12.30 Median $29.51 Typical High $38.02 | Facility | None | $12.30 | $29.51 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $30.20 | Professional | None | $11.22 | $11.22 | $30.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.30 Median $26.30 Typical High $74.13 | Facility | None | $12.30 | $26.30 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.55 Median $11.22 Typical High $17.78 | Professional | None | $9.55 | $11.22 | $17.78 |
Aultcare Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
CareSource Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Facility | None | $10.23 | $10.23 | $10.23 |
CareSource Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $23.99 Typical High $37.15 | Facility | None | $20.89 | $23.99 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $16.60 | Professional | None | $11.22 | $11.22 | $16.60 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $16.60 Median $23.99 Typical High $32.36 | Facility | None | $16.60 | $23.99 | $32.36 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $16.60 | Professional | None | $11.22 | $11.22 | $16.60 |
Molina Setting Professional Modifier None Typical Low $12.30 Median $14.13 Typical High $16.22 | Professional | None | $12.30 | $14.13 | $16.22 |
SummaCare Setting Professional Modifier None Typical Low $11.22 Median $12.30 Typical High $22.39 | Professional | None | $11.22 | $12.30 | $22.39 |
United Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $16.98 | Professional | None | $11.22 | $11.22 | $16.98 |
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 $5.62 Median $5.62 Typical High $15.14 | Professional | 52 · Reduced service | $5.62 | $5.62 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.24 Typical High $6.03 | Professional | 53 · Discontinued | $2.24 | $2.24 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.66 Typical High $4.47 | Professional | 55 · Aftercare only | $1.66 | $1.66 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $3.02 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $3.02 |
Where Ohio sits
The same service costs 3.3 times more in Alaska than in Texas. 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· 12th of 51
$12.02
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.