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 $38.02 Median $42.66 Typical High $112.20 | Facility | None | $38.02 | $42.66 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $44.67 | Professional | None | $38.02 | $38.02 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $42.66 Median $93.33 Typical High $257.04 | Facility | None | $42.66 | $93.33 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $54.95 | Professional | None | $38.02 | $38.02 | $54.95 |
CareSource Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
CareSource Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $48.98 | Professional | None | $36.31 | $36.31 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $81.28 Typical High $125.89 | Facility | None | $72.44 | $81.28 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $43.65 | Professional | None | $38.02 | $38.02 | $43.65 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $75.86 Median $81.28 Typical High $109.65 | Facility | None | $75.86 | $81.28 | $109.65 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | None | $38.02 | $38.02 | $51.29 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $43.65 Typical High $50.12 | Professional | None | $38.02 | $43.65 | $50.12 |
SummaCare Setting Professional Modifier None Typical Low $38.02 Median $39.81 Typical High $46.77 | Professional | None | $38.02 | $39.81 | $46.77 |
United Setting Professional Modifier None Typical Low $36.31 Median $41.69 Typical High $44.67 | Professional | None | $36.31 | $41.69 | $44.67 |
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 $19.05 Median $19.05 Typical High $22.39 | Professional | 52 · Reduced service | $19.05 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $8.91 | Professional | 53 · Discontinued | $7.59 | $7.59 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $6.61 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $4.47 |
Where Ohio sits
The same service costs 1.6 times more in Alaska than in South Carolina. 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· 37th of 51
$38.02
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.