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 $25.70 Median $25.70 Typical High $100.00 | Facility | None | $25.70 | $25.70 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $75.86 | Professional | None | $25.70 | $25.70 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $29.51 Median $64.57 Typical High $177.83 | Facility | None | $29.51 | $64.57 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $46.77 | Professional | None | $25.70 | $25.70 | $46.77 |
CareSource Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
CareSource Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $54.95 Typical High $85.11 | Facility | None | $47.86 | $54.95 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $37.15 | Professional | None | $25.70 | $25.70 | $37.15 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $52.48 Median $54.95 Typical High $74.13 | Facility | None | $52.48 | $54.95 | $74.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $47.86 | Professional | None | $25.70 | $25.70 | $47.86 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $32.36 Typical High $38.90 | Professional | None | $28.18 | $32.36 | $38.90 |
SummaCare Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $51.29 | Professional | None | $25.70 | $28.18 | $51.29 |
United Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $40.74 | Professional | None | $27.54 | $27.54 | $40.74 |
3 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 55 · Aftercare only Typical Low $3.80 Median $3.80 Typical High $11.48 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $7.59 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $7.59 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | JZ · No drug discarded | $30.90 | $30.90 | $30.90 |
Where Ohio sits
The same service costs 1.9 times more in Alaska than in New Jersey. 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
$27.54
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.