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 $12.02 Median $33.11 Typical High $40.74 | Facility | None | $12.02 | $33.11 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $89.13 | Professional | None | $12.02 | $12.02 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.49 Median $28.84 Typical High $81.28 | Facility | None | $13.49 | $28.84 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $22.39 | Professional | None | $12.02 | $12.02 | $22.39 |
CareSource Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
CareSource Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $25.70 Typical High $39.81 | Facility | None | $22.91 | $25.70 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $25.12 | Professional | None | $12.02 | $12.02 | $25.12 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $23.44 Median $25.70 Typical High $34.67 | Facility | None | $23.44 | $25.70 | $34.67 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $25.12 | Professional | None | $12.02 | $12.02 | $25.12 |
Molina Setting Professional Modifier None Typical Low $13.18 Median $15.49 Typical High $17.38 | Professional | None | $13.18 | $15.49 | $17.38 |
SummaCare Setting Professional Modifier None Typical Low $12.02 Median $13.18 Typical High $23.99 | Professional | None | $12.02 | $13.18 | $23.99 |
United Setting Professional Modifier None Typical Low $12.30 Median $18.20 Typical High $67.61 | Professional | None | $12.30 | $18.20 | $67.61 |
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 $6.03 Median $6.03 Typical High $64.57 | Professional | 52 · Reduced service | $6.03 | $6.03 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.40 Typical High $25.70 | Professional | 53 · Discontinued | $2.40 | $2.40 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $19.50 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $12.88 | Professional | 56 · Pre-op care only | $1.20 | $1.20 | $12.88 |
Where Ohio sits
The same service costs 1.9 times more in Alaska than in Pennsylvania. 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· 19th of 51
$13.49
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.