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 $22.91 Median $38.02 Typical High $77.62 | Facility | None | $22.91 | $38.02 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $26.92 Typical High $63.10 | Professional | None | $22.91 | $26.92 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.12 Median $53.70 Typical High $151.36 | Facility | None | $25.12 | $53.70 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $22.91 Typical High $36.31 | Professional | None | $19.50 | $22.91 | $36.31 |
Aultcare Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
CareSource Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
CareSource Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $50.12 Typical High $75.86 | Facility | None | $43.65 | $50.12 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $20.89 Median $42.66 Typical High $70.79 | Facility | None | $20.89 | $42.66 | $70.79 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Molina Setting Professional Modifier None Typical Low $24.55 Median $28.84 Typical High $32.36 | Professional | None | $24.55 | $28.84 | $32.36 |
SummaCare Setting Professional Modifier None Typical Low $22.91 Median $25.12 Typical High $45.71 | Professional | None | $22.91 | $25.12 | $45.71 |
United Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $33.11 | Professional | None | $22.39 | $22.39 | $33.11 |
5 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 $11.48 Median $11.48 Typical High $18.62 | Professional | 52 · Reduced service | $11.48 | $11.48 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.57 Typical High $7.41 | Professional | 53 · Discontinued | $4.57 | $4.57 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.47 Typical High $5.50 | Professional | 55 · Aftercare only | $3.47 | $3.47 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.29 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.29 | $2.29 | $3.72 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | JZ · No drug discarded | $19.50 | $19.50 | $19.50 |
Where Ohio sits
The same service costs 2.0 times more in Minnesota than in Hawaii. 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· 12th of 51
$25.12
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.