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 $19.05 Median $40.74 Typical High $63.10 | Facility | None | $19.05 | $40.74 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $20.89 Typical High $52.48 | Professional | None | $19.05 | $20.89 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $18.20 Median $40.74 Typical High $123.03 | Facility | None | $18.20 | $40.74 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.22 Median $19.05 Typical High $28.84 | Professional | None | $16.22 | $19.05 | $28.84 |
Aultcare Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
CareSource Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
CareSource Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $40.74 Typical High $63.10 | Facility | None | $35.48 | $40.74 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $30.20 | Professional | None | $19.05 | $19.05 | $30.20 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $13.80 Median $29.51 Typical High $53.70 | Facility | None | $13.80 | $29.51 | $53.70 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $30.20 | Professional | None | $19.05 | $19.05 | $30.20 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $17.78 Typical High $26.30 | Professional | None | $14.79 | $17.78 | $26.30 |
SummaCare Setting Professional Modifier None Typical Low $19.05 Median $20.89 Typical High $38.02 | Professional | None | $19.05 | $20.89 | $38.02 |
United Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $18.20 | Professional | None | $12.02 | $12.02 | $18.20 |
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 $9.55 Median $9.55 Typical High $14.45 | Professional | 52 · Reduced service | $9.55 | $9.55 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $5.75 | Professional | 53 · Discontinued | $3.80 | $3.80 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $4.37 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $2.88 | Professional | 56 · Pre-op care only | $1.91 | $1.91 | $2.88 |
Where Ohio sits
The same service costs 2.7 times more in Wyoming than in Maryland. 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· 13th of 51
$19.05
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.