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 $19.50 Median $32.36 Typical High $35.48 | Facility | None | $19.50 | $32.36 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $39.81 | Professional | None | $19.50 | $19.50 | $39.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.95 Median $32.36 Typical High $58.88 | Facility | None | $19.95 | $32.36 | $58.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.05 Median $19.50 Typical High $35.48 | Professional | None | $19.05 | $19.50 | $35.48 |
CareSource Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
CareSource Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $41.69 Typical High $63.10 | Facility | None | $36.31 | $41.69 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $26.30 | Professional | None | $19.50 | $19.50 | $26.30 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $35.48 Median $41.69 Typical High $54.95 | Facility | None | $35.48 | $41.69 | $54.95 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $26.30 | Professional | None | $19.50 | $19.50 | $26.30 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $23.99 Typical High $26.92 | Professional | None | $20.42 | $23.99 | $26.92 |
SummaCare Setting Professional Modifier None Typical Low $19.50 Median $21.38 Typical High $38.02 | Professional | None | $19.50 | $21.38 | $38.02 |
United Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
United Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $27.54 | Professional | None | $18.62 | $18.62 | $27.54 |
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 $9.55 Median $9.55 Typical High $19.95 | Professional | 52 · Reduced service | $9.55 | $9.55 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $7.94 | Professional | 53 · Discontinued | $3.89 | $3.89 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $2.88 Typical High $6.03 | Professional | 55 · Aftercare only | $2.88 | $2.88 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $3.98 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $3.98 |
Where Ohio sits
The same service costs 1.9 times more in Alaska than in Rhode Island. 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· 5th of 51
$23.44
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.