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 $97.72 Typical High $154.88 | Facility | None | $28.84 | $97.72 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $31.62 | Professional | None | $28.84 | $28.84 | $31.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.90 Median $64.57 Typical High $186.21 | Facility | None | $30.90 | $64.57 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $39.81 | Professional | None | $28.84 | $28.84 | $39.81 |
CareSource Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
CareSource Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $29.51 | Professional | None | $21.88 | $21.88 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $61.66 Typical High $95.50 | Facility | None | $26.30 | $61.66 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | None | $28.84 | $28.84 | $38.90 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $26.30 Median $61.66 Typical High $83.18 | Facility | None | $26.30 | $61.66 | $83.18 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | None | $28.84 | $28.84 | $38.90 |
Molina Setting Professional Modifier None Typical Low $24.55 Median $28.84 Typical High $36.31 | Professional | None | $24.55 | $28.84 | $36.31 |
SummaCare Setting Professional Modifier None Typical Low $28.84 Median $30.20 Typical High $35.48 | Professional | None | $28.84 | $30.20 | $35.48 |
United Setting Professional Modifier None Typical Low $22.91 Median $25.70 Typical High $27.54 | Professional | None | $22.91 | $25.70 | $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 $14.45 Median $14.45 Typical High $17.38 | Professional | 52 · Reduced service | $14.45 | $14.45 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $6.92 | Professional | 53 · Discontinued | $5.75 | $5.75 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $5.25 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $3.47 |
Where Ohio sits
The same service costs 2.8 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· 39th of 51
$28.84
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.