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 $43.65 Median $138.04 Typical High $165.96 | Facility | None | $43.65 | $138.04 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $302.00 | Professional | None | $43.65 | $43.65 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $58.88 Median $125.89 Typical High $354.81 | Facility | None | $58.88 | $125.89 | $354.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $44.67 Typical High $93.33 | Professional | None | $43.65 | $44.67 | $93.33 |
CareSource Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
CareSource Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $93.33 Typical High $144.54 | Facility | None | $83.18 | $93.33 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $93.33 Median $102.33 Typical High $125.89 | Facility | None | $93.33 | $102.33 | $125.89 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $57.54 | Professional | None | $43.65 | $43.65 | $57.54 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $67.61 Typical High $83.18 | Professional | None | $54.95 | $67.61 | $83.18 |
SummaCare Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $87.10 | Professional | None | $43.65 | $47.86 | $87.10 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $81.28 | Professional | None | $54.95 | $54.95 | $81.28 |
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 $21.88 Median $21.88 Typical High $151.36 | Professional | 52 · Reduced service | $21.88 | $21.88 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $60.26 | Professional | 53 · Discontinued | $8.71 | $8.71 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $45.71 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $30.20 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $30.20 |
Where Ohio sits
The same service costs 2.0 times more in Alaska than in Wyoming. 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· 33rd of 51
$54.95
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.