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 $9.55 Median $9.55 Typical High $34.67 | Facility | None | $9.55 | $9.55 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $34.67 | Professional | None | $9.55 | $9.55 | $34.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.31 Median $5.75 Typical High $21.38 | Facility | None | $3.31 | $5.75 | $21.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $27.54 Typical High $38.90 | Professional | None | $20.89 | $27.54 | $38.90 |
CareSource Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $29.51 | Facility | None | $21.88 | $21.88 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $12.02 | Professional | None | $10.23 | $10.23 | $12.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $29.51 | Facility | None | $21.88 | $21.88 | $29.51 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $17.38 | Professional | None | $10.23 | $10.23 | $17.38 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $34.67 Typical High $39.81 | Professional | None | $30.20 | $34.67 | $39.81 |
SummaCare Setting Professional Modifier None Typical Low $10.72 Median $11.75 Typical High $20.89 | Professional | None | $10.72 | $11.75 | $20.89 |
United Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
United Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $14.79 | Professional | None | $10.00 | $10.00 | $14.79 |
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 $4.79 Median $4.79 Typical High $17.38 | Professional | 52 · Reduced service | $4.79 | $4.79 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $1.91 Typical High $7.08 | Professional | 53 · Discontinued | $1.91 | $1.91 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.45 Typical High $5.25 | Professional | 55 · Aftercare only | $1.45 | $1.45 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $0.95 Typical High $3.47 | Professional | 56 · Pre-op care only | $0.95 | $0.95 | $3.47 |
Where Ohio sits
The same service costs 9.1 times more in Alabama than in 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· 16th of 51
$12.59
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.