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 $43.65 Median $112.20 Typical High $204.17 | Facility | None | $43.65 | $112.20 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $181.97 | Professional | None | $60.26 | $60.26 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $141.25 Typical High $407.38 | Facility | None | $67.61 | $141.25 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $52.48 Typical High $95.50 | Professional | None | $51.29 | $52.48 | $95.50 |
CareSource Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $147.91 | Facility | None | $109.65 | $109.65 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $60.26 | Professional | None | $51.29 | $51.29 | $60.26 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $15.85 Median $109.65 Typical High $147.91 | Facility | None | $15.85 | $109.65 | $147.91 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $66.07 | Professional | None | $51.29 | $51.29 | $66.07 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $30.20 Typical High $35.48 | Professional | None | $26.92 | $30.20 | $35.48 |
SummaCare Setting Professional Modifier None Typical Low $52.48 Median $58.88 Typical High $104.71 | Professional | None | $52.48 | $58.88 | $104.71 |
United Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $93.33 | Professional | None | $63.10 | $63.10 | $93.33 |
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 $30.20 Median $30.20 Typical High $91.20 | Professional | 52 · Reduced service | $30.20 | $30.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $36.31 | Professional | 53 · Discontinued | $12.02 | $12.02 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $27.54 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $18.20 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $18.20 |
Where Ohio sits
The same service costs 3.0 times more in Kansas than in South Carolina. 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· 37th of 51
$60.26
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.