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 $14.13 Median $14.13 Typical High $125.89 | Facility | None | $14.13 | $14.13 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $97.72 | Professional | None | $14.13 | $14.13 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.14 Median $24.55 Typical High $42.66 | Facility | None | $15.14 | $24.55 | $42.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $26.30 | Professional | None | $14.13 | $14.13 | $26.30 |
CareSource Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
CareSource Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $30.20 Typical High $46.77 | Facility | None | $26.30 | $30.20 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $25.70 | Professional | None | $14.13 | $14.13 | $25.70 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $26.30 Median $30.20 Typical High $39.81 | Facility | None | $26.30 | $30.20 | $39.81 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $25.70 | Professional | None | $14.13 | $14.13 | $25.70 |
Molina Setting Professional Modifier None Typical Low $15.49 Median $18.62 Typical High $20.89 | Professional | None | $15.49 | $18.62 | $20.89 |
SummaCare Setting Professional Modifier None Typical Low $14.13 Median $15.49 Typical High $28.18 | Professional | None | $14.13 | $15.49 | $28.18 |
United Setting Professional Modifier None Typical Low $13.80 Median $15.49 Typical High $17.78 | Professional | None | $13.80 | $15.49 | $17.78 |
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 $7.08 Median $7.08 Typical High $48.98 | Professional | 52 · Reduced service | $7.08 | $7.08 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $19.50 | Professional | 53 · Discontinued | $2.82 | $2.82 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.09 Typical High $14.45 | Professional | 55 · Aftercare only | $2.09 | $2.09 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.41 Typical High $9.77 | Professional | 56 · Pre-op care only | $1.41 | $1.41 | $9.77 |
Where Ohio sits
The same service costs 1.8 times more in Alaska 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· 9th of 51
$16.98
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.