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 $120.23 Typical High $147.91 | Facility | None | $43.65 | $120.23 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $70.79 | Professional | None | $43.65 | $43.65 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $45.71 Median $74.13 Typical High $131.83 | Facility | None | $45.71 | $74.13 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $79.43 | Professional | None | $43.65 | $43.65 | $79.43 |
CareSource Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
CareSource Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $93.33 Typical High $144.54 | Facility | None | $42.66 | $93.33 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $50.12 | Professional | None | $43.65 | $43.65 | $50.12 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $42.66 Median $93.33 Typical High $125.89 | Facility | None | $42.66 | $93.33 | $125.89 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $50.12 | Professional | None | $43.65 | $43.65 | $50.12 |
Molina Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $61.66 | Professional | None | $46.77 | $54.95 | $61.66 |
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 Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $63.10 | Professional | None | $42.66 | $42.66 | $63.10 |
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 $35.48 | Professional | 52 · Reduced service | $21.88 | $21.88 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $14.13 | Professional | 53 · Discontinued | $8.71 | $8.71 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $10.72 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $7.08 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $7.08 |
Where Ohio sits
The same service costs 1.6 times more in Arizona 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· 5th of 51
$53.70
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.