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 $69.18 Median $141.25 Typical High $645.65 | Facility | None | $69.18 | $141.25 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $758.58 | Professional | None | $41.69 | $41.69 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $87.10 Typical High $141.25 | Facility | None | $50.12 | $87.10 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $42.66 Typical High $87.10 | Professional | None | $41.69 | $42.66 | $87.10 |
CareSource Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
CareSource Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $89.13 Typical High $138.04 | Facility | None | $57.54 | $89.13 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $190.55 | Professional | None | $41.69 | $41.69 | $190.55 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $57.54 Median $93.33 Typical High $125.89 | Facility | None | $57.54 | $93.33 | $125.89 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $275.42 | Professional | None | $41.69 | $41.69 | $275.42 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $61.66 Typical High $81.28 | Professional | None | $51.29 | $61.66 | $81.28 |
SummaCare Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $83.18 | Professional | None | $41.69 | $45.71 | $83.18 |
United Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
United Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $109.65 | Professional | None | $50.12 | $54.95 | $109.65 |
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 $20.89 Median $20.89 Typical High $380.19 | Professional | 52 · Reduced service | $20.89 | $20.89 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $151.36 | Professional | 53 · Discontinued | $8.32 | $8.32 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $114.82 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $75.86 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $75.86 |
Where Ohio sits
The same service costs 24.5 times more in Alabama than in Georgia. 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· 14th 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.