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 $31.62 Median $51.29 Typical High $95.50 | Facility | None | $31.62 | $51.29 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $46.77 Typical High $91.20 | Professional | None | $28.18 | $46.77 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.20 Median $66.07 Typical High $181.97 | Facility | None | $30.20 | $66.07 | $181.97 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $53.70 | Professional | None | $25.70 | $28.18 | $53.70 |
Aultcare Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
CareSource Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
CareSource Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $60.26 Typical High $93.33 | Facility | None | $52.48 | $60.26 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $43.65 | Professional | None | $28.18 | $28.18 | $43.65 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $45.71 Median $60.26 Typical High $81.28 | Facility | None | $45.71 | $60.26 | $81.28 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $43.65 | Professional | None | $28.18 | $28.18 | $43.65 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $33.88 Typical High $39.81 | Professional | None | $28.18 | $33.88 | $39.81 |
SummaCare Setting Professional Modifier None Typical Low $28.18 Median $30.90 Typical High $56.23 | Professional | None | $28.18 | $30.90 | $56.23 |
United Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $36.31 | Professional | None | $24.55 | $24.55 | $36.31 |
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 $14.13 Median $14.13 Typical High $34.67 | Professional | 52 · Reduced service | $14.13 | $14.13 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $14.13 | Professional | 53 · Discontinued | $5.62 | $5.62 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $10.47 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $7.08 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $7.08 |
Where Ohio sits
The same service costs 2.2 times more in Alaska than in Oklahoma. 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· 9th 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.