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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $147.91 Typical High $407.38 | Facility | None | $67.61 | $147.91 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $67.61 Typical High $131.83 | Professional | None | $64.57 | $67.61 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $186.21 | Facility | None | $138.04 | $138.04 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | None | $63.10 | $63.10 | $75.86 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $186.21 | Facility | None | $138.04 | $138.04 | $186.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | None | $63.10 | $63.10 | $75.86 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $239.88 | Professional | None | $181.97 | $204.17 | $239.88 |
SummaCare Setting Professional Modifier None Typical Low $66.07 Median $72.44 Typical High $131.83 | Professional | None | $66.07 | $72.44 | $131.83 |
United Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $93.33 | Professional | None | $63.10 | $63.10 | $93.33 |
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 $30.20 Median $30.20 Typical High $380.19 | Professional | 52 · Reduced service | $30.20 | $30.20 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $151.36 | Professional | 53 · Discontinued | $12.02 | $12.02 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $114.82 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $75.86 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $75.86 |
Where Ohio sits
The same service costs 3.2 times more in Kansas than in Arkansas. 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· 17th of 51
$67.61
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.