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 $28.84 Median $69.18 Typical High $89.13 | Facility | None | $28.84 | $69.18 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $69.18 | Professional | None | $25.12 | $25.12 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.12 Median $53.70 Typical High $162.18 | Facility | None | $25.12 | $53.70 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $34.67 | Professional | None | $25.12 | $25.12 | $34.67 |
Aultcare Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
CareSource Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
CareSource Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $28.84 | Professional | None | $21.38 | $21.38 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $53.70 Typical High $81.28 | Facility | None | $46.77 | $53.70 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $26.30 | Professional | None | $25.12 | $25.12 | $26.30 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $31.62 Median $53.70 Typical High $97.72 | Facility | None | $31.62 | $53.70 | $97.72 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $35.48 | Professional | None | $25.12 | $25.12 | $35.48 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $25.12 Typical High $29.51 | Professional | None | $16.60 | $25.12 | $29.51 |
SummaCare Setting Professional Modifier None Typical Low $25.12 Median $26.30 Typical High $30.90 | Professional | None | $25.12 | $26.30 | $30.90 |
United Setting Professional Modifier None Typical Low $15.85 Median $17.78 Typical High $74.13 | Professional | None | $15.85 | $17.78 | $74.13 |
5 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 $12.30 Median $12.30 Typical High $13.80 | Professional | 52 · Reduced service | $12.30 | $12.30 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $5.50 | Professional | 53 · Discontinued | $5.01 | $5.01 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $4.07 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.75 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $16.60 Median $20.89 Typical High $25.12 | Professional | JZ · No drug discarded | $16.60 | $20.89 | $25.12 |
Where Ohio sits
The same service costs 1.9 times more in Wyoming than in Arizona. 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· 17th of 51
$25.12
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.