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 $18.20 Median $18.20 Typical High $57.54 | Facility | None | $18.20 | $18.20 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $56.23 | Professional | None | $18.20 | $18.20 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $18.20 Median $29.51 Typical High $45.71 | Facility | None | $18.20 | $29.51 | $45.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $33.88 | Professional | None | $18.20 | $18.20 | $33.88 |
CareSource Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
CareSource Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $38.90 Typical High $60.26 | Facility | None | $33.88 | $38.90 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $25.12 | Professional | None | $18.20 | $18.20 | $25.12 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $33.88 Median $38.90 Typical High $52.48 | Facility | None | $33.88 | $38.90 | $52.48 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $36.31 | Professional | None | $18.20 | $18.20 | $36.31 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $22.91 Typical High $25.70 | Professional | None | $19.50 | $22.91 | $25.70 |
SummaCare Setting Professional Modifier None Typical Low $18.20 Median $19.95 Typical High $36.31 | Professional | None | $18.20 | $19.95 | $36.31 |
United Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
United Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $26.92 | Professional | None | $18.20 | $18.20 | $26.92 |
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 $9.12 Median $9.12 Typical High $28.18 | Professional | 52 · Reduced service | $9.12 | $9.12 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $11.22 | Professional | 53 · Discontinued | $3.63 | $3.63 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $8.32 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $5.62 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $5.62 |
Where Ohio sits
The same service costs 1.6 times more in Arizona than in North Dakota. 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· 12th of 51
$20.89
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.