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 $61.66 Median $151.36 Typical High $190.55 | Facility | None | $61.66 | $151.36 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $380.19 | Professional | None | $54.95 | $54.95 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $58.88 Median $128.82 Typical High $354.81 | Facility | None | $58.88 | $128.82 | $354.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $102.33 | Professional | None | $54.95 | $54.95 | $102.33 |
CareSource Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
CareSource Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $117.49 Typical High $181.97 | Facility | None | $104.71 | $117.49 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $109.65 | Professional | None | $54.95 | $54.95 | $109.65 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $104.71 Median $117.49 Typical High $158.49 | Facility | None | $104.71 | $117.49 | $158.49 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $109.65 | Professional | None | $54.95 | $54.95 | $109.65 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $79.43 | Professional | None | $60.26 | $70.79 | $79.43 |
SummaCare Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $109.65 | Professional | None | $54.95 | $60.26 | $109.65 |
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 $27.54 Median $27.54 Typical High $190.55 | Professional | 52 · Reduced service | $27.54 | $27.54 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $75.86 | Professional | 53 · Discontinued | $10.96 | $10.96 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $57.54 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $38.02 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $38.02 |
Where Ohio sits
The same service costs 2.7 times more in Oklahoma than in West Virginia. 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· 24th of 51
$60.26
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.