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 $11.48 Median $33.11 Typical High $39.81 | Facility | None | $11.48 | $33.11 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $12.59 Typical High $39.81 | Professional | None | $11.48 | $12.59 | $39.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.30 Median $18.62 Typical High $34.67 | Facility | None | $12.30 | $18.62 | $34.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $20.89 | Professional | None | $11.48 | $11.48 | $20.89 |
Aultcare Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
CareSource Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
CareSource Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $24.55 Typical High $37.15 | Facility | None | $21.38 | $24.55 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $16.60 | Professional | None | $11.48 | $11.48 | $16.60 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $21.88 Median $24.55 Typical High $32.36 | Facility | None | $21.88 | $24.55 | $32.36 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $16.60 | Professional | None | $11.48 | $11.48 | $16.60 |
Molina Setting Professional Modifier None Typical Low $12.88 Median $15.49 Typical High $17.38 | Professional | None | $12.88 | $15.49 | $17.38 |
SummaCare Setting Professional Modifier None Typical Low $11.48 Median $12.59 Typical High $22.39 | Professional | None | $11.48 | $12.59 | $22.39 |
United Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
United Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $16.98 | Professional | None | $11.75 | $11.75 | $16.98 |
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 $5.62 Median $5.62 Typical High $29.51 | Professional | 52 · Reduced service | $5.62 | $5.62 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $11.75 | Professional | 53 · Discontinued | $2.29 | $2.29 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $8.91 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $5.89 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $5.89 |
Where Ohio sits
The same service costs 1.8 times more in Alaska than in Georgia. 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· 8th of 51
$14.45
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.