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 $42.66 Median $42.66 Typical High $79.43 | Facility | None | $42.66 | $42.66 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $61.66 | Professional | None | $42.66 | $42.66 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $43.65 Median $66.07 Typical High $125.89 | Facility | None | $43.65 | $66.07 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $42.66 Typical High $79.43 | Professional | None | $41.69 | $42.66 | $79.43 |
CareSource Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
CareSource Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $91.20 Typical High $141.25 | Facility | None | $81.28 | $91.20 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $56.23 | Professional | None | $42.66 | $42.66 | $56.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $75.86 Median $91.20 Typical High $123.03 | Facility | None | $75.86 | $91.20 | $123.03 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $56.23 | Professional | None | $42.66 | $42.66 | $56.23 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $53.70 Typical High $60.26 | Professional | None | $44.67 | $53.70 | $60.26 |
SummaCare Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $85.11 | Professional | None | $42.66 | $46.77 | $85.11 |
United Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
United Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $60.26 | Professional | None | $40.74 | $40.74 | $60.26 |
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 $21.38 Median $21.38 Typical High $30.20 | Professional | 52 · Reduced service | $21.38 | $21.38 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $12.30 | Professional | 53 · Discontinued | $8.51 | $8.51 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $9.12 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $6.17 |
Where Ohio sits
The same service costs 1.7 times more in Arizona than in Maryland. 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· 3rd of 51
$51.29
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.