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 $8.51 Median $15.49 Typical High $47.86 | Facility | None | $8.51 | $15.49 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.00 Median $21.88 Typical High $60.26 | Facility | None | $10.00 | $21.88 | $60.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.51 Median $8.71 Typical High $17.78 | Professional | None | $8.51 | $8.71 | $17.78 |
Aultcare Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
CareSource Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
CareSource Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $18.20 Typical High $28.18 | Facility | None | $16.22 | $18.20 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $44.67 | Professional | None | $8.51 | $8.51 | $44.67 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $12.59 Median $19.95 Typical High $91.20 | Facility | None | $12.59 | $19.95 | $91.20 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $44.67 | Professional | None | $8.51 | $8.51 | $44.67 |
Molina Setting Professional Modifier None Typical Low $10.23 Median $12.30 Typical High $15.85 | Professional | None | $10.23 | $12.30 | $15.85 |
SummaCare Setting Professional Modifier None Typical Low $8.51 Median $9.33 Typical High $16.98 | Professional | None | $8.51 | $9.33 | $16.98 |
United Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $13.80 | Professional | None | $9.33 | $9.33 | $13.80 |
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 $4.27 Median $4.27 Typical High $75.86 | Professional | 52 · Reduced service | $4.27 | $4.27 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.70 Typical High $30.20 | Professional | 53 · Discontinued | $1.70 | $1.70 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $22.91 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.85 Typical High $15.14 | Professional | 56 · Pre-op care only | $0.85 | $0.85 | $15.14 |
Where Ohio sits
The same service costs 6.5 times more in Oklahoma than in Alabama. 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· 42nd of 51
$9.33
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.