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 $24.55 Median $45.71 Typical High $83.18 | Facility | None | $24.55 | $45.71 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $87.10 | Professional | None | $24.55 | $24.55 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.30 Median $42.66 Typical High $75.86 | Facility | None | $26.30 | $42.66 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $40.74 | Professional | None | $24.55 | $24.55 | $40.74 |
CareSource Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
CareSource Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $52.48 Typical High $81.28 | Facility | None | $46.77 | $52.48 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $28.84 | Professional | None | $24.55 | $24.55 | $28.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $45.71 Median $52.48 Typical High $70.79 | Facility | None | $45.71 | $52.48 | $70.79 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $28.84 | Professional | None | $24.55 | $24.55 | $28.84 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $30.90 Typical High $34.67 | Professional | None | $26.30 | $30.90 | $34.67 |
SummaCare Setting Professional Modifier None Typical Low $24.55 Median $26.92 Typical High $48.98 | Professional | None | $24.55 | $26.92 | $48.98 |
United Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
United Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $35.48 | Professional | None | $23.99 | $23.99 | $35.48 |
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 $12.30 Median $12.30 Typical High $43.65 | Professional | 52 · Reduced service | $12.30 | $12.30 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $17.38 | Professional | 53 · Discontinued | $4.90 | $4.90 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $13.18 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $8.71 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $8.71 |
Where Ohio sits
The same service costs 234.4 times more in Alabama than in Maryland. 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· 4th of 51
$30.20
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.