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 $39.81 Median $39.81 Typical High $181.97 | Facility | None | $39.81 | $39.81 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $141.25 | Professional | None | $39.81 | $39.81 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $40.74 Median $69.18 Typical High $120.23 | Facility | None | $40.74 | $69.18 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $39.81 Typical High $74.13 | Professional | None | $38.90 | $39.81 | $74.13 |
CareSource Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
CareSource Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Facility | None | $83.18 | $83.18 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $45.71 | Professional | None | $38.90 | $38.90 | $45.71 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Facility | None | $83.18 | $83.18 | $112.20 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $45.71 | Professional | None | $38.90 | $38.90 | $45.71 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $50.12 Typical High $57.54 | Professional | None | $43.65 | $50.12 | $57.54 |
SummaCare Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $79.43 | Professional | None | $40.74 | $44.67 | $79.43 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
United Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $58.88 | Professional | None | $39.81 | $39.81 | $58.88 |
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 $19.95 Median $19.95 Typical High $70.79 | Professional | 52 · Reduced service | $19.95 | $19.95 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $28.18 | Professional | 53 · Discontinued | $7.94 | $7.94 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $20.89 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $14.13 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $14.13 |
Where Ohio sits
The same service costs 1.6 times more in Arizona 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· 12th of 51
$44.67
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.