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 $77.62 Median $165.96 Typical High $263.03 | Facility | None | $77.62 | $165.96 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $363.08 | Professional | None | $77.62 | $77.62 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $165.96 Typical High $501.19 | Facility | None | $70.79 | $165.96 | $501.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $117.49 | Professional | None | $66.07 | $77.62 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
CareSource Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $165.96 Typical High $257.04 | Facility | None | $147.91 | $165.96 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $97.72 | Professional | None | $77.62 | $77.62 | $97.72 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $89.13 Median $165.96 Typical High $223.87 | Facility | None | $89.13 | $165.96 | $223.87 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $141.25 | Professional | None | $77.62 | $77.62 | $141.25 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $72.44 Typical High $109.65 | Professional | None | $58.88 | $72.44 | $109.65 |
SummaCare Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $154.88 | Professional | None | $77.62 | $85.11 | $154.88 |
United Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $69.18 | Professional | None | $46.77 | $46.77 | $69.18 |
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 $38.90 Median $38.90 Typical High $181.97 | Professional | 52 · Reduced service | $38.90 | $38.90 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $72.44 | Professional | 53 · Discontinued | $15.49 | $15.49 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $54.95 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $36.31 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $36.31 |
Where Ohio sits
The same service costs 3.6 times more in Texas than in Kansas. 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· 28th of 51
$77.62
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.