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 $56.23 Median $63.10 Typical High $204.17 | Facility | None | $56.23 | $63.10 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $154.88 | Professional | None | $56.23 | $56.23 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $61.66 Median $131.83 Typical High $371.54 | Facility | None | $61.66 | $131.83 | $371.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $104.71 | Professional | None | $56.23 | $56.23 | $104.71 |
CareSource Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
CareSource Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $74.13 | Professional | None | $50.12 | $54.95 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $123.03 Typical High $186.21 | Facility | None | $107.15 | $123.03 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $104.71 Median $123.03 Typical High $162.18 | Facility | None | $104.71 | $123.03 | $162.18 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $77.62 | Professional | None | $54.95 | $60.26 | $77.62 |
SummaCare Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $109.65 | Professional | None | $56.23 | $60.26 | $109.65 |
United Setting Professional Modifier None Typical Low $21.88 Median $54.95 Typical High $74.13 | Professional | None | $21.88 | $54.95 | $74.13 |
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 $28.18 Median $28.18 Typical High $77.62 | Professional | 52 · Reduced service | $28.18 | $28.18 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $30.90 | Professional | 53 · Discontinued | $11.48 | $11.48 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $23.44 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $15.49 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $15.49 |
Where Ohio sits
The same service costs 1.6 times more in Alaska than in Louisiana. 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
$56.23
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.