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 $74.13 Median $74.13 Typical High $223.87 | Facility | None | $74.13 | $74.13 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $169.82 | Professional | None | $74.13 | $74.13 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $131.83 Typical High $229.09 | Facility | None | $81.28 | $131.83 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $144.54 | Professional | None | $74.13 | $75.86 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $162.18 Typical High $245.47 | Facility | None | $141.25 | $162.18 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $95.50 | Professional | None | $74.13 | $74.13 | $95.50 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $144.54 Median $162.18 Typical High $213.80 | Facility | None | $144.54 | $162.18 | $213.80 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $95.50 | Professional | None | $74.13 | $74.13 | $95.50 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $95.50 Typical High $109.65 | Professional | None | $83.18 | $95.50 | $109.65 |
SummaCare Setting Professional Modifier None Typical Low $74.13 Median $83.18 Typical High $147.91 | Professional | None | $74.13 | $83.18 | $147.91 |
United Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $112.20 | Professional | None | $75.86 | $75.86 | $112.20 |
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 $37.15 Median $37.15 Typical High $85.11 | Professional | 52 · Reduced service | $37.15 | $37.15 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $33.88 | Professional | 53 · Discontinued | $14.79 | $14.79 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $25.70 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $16.98 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $16.98 |
Where Ohio sits
The same service costs 1.5 times more in Alaska than in Delaware. 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· 2nd of 51
$95.50
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.