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 $36.31 Median $97.72 Typical High $120.23 | Facility | None | $36.31 | $97.72 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $74.13 | Professional | None | $36.31 | $36.31 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $40.74 Median $87.10 Typical High $245.47 | Facility | None | $40.74 | $87.10 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $38.90 | Professional | None | $1.29 | $1.29 | $38.90 |
CareSource Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Facility | None | $2.34 | $2.34 | $2.34 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $109.65 | Facility | None | $83.18 | $83.18 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $44.67 | Professional | None | $38.02 | $38.02 | $44.67 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $109.65 | Facility | None | $83.18 | $83.18 | $109.65 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $44.67 | Professional | None | $38.02 | $38.02 | $44.67 |
Molina Setting Professional Modifier None Typical Low $5.25 Median $6.03 Typical High $6.92 | Professional | None | $5.25 | $6.03 | $6.92 |
SummaCare Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $79.43 | Professional | None | $39.81 | $43.65 | $79.43 |
United Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $56.23 | Professional | None | $37.15 | $37.15 | $56.23 |
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 $18.20 Median $18.20 Typical High $37.15 | Professional | 52 · Reduced service | $18.20 | $18.20 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $14.79 | Professional | 53 · Discontinued | $7.24 | $7.24 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $11.22 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $7.41 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $7.41 |
Where Ohio sits
The same service costs 20.4 times more in Arizona 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· 43rd of 51
$36.31
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.