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 $28.84 Typical High $81.28 | Facility | None | $28.84 | $28.84 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $30.90 | Professional | None | $28.84 | $28.84 | $30.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $70.79 Typical High $194.98 | Facility | None | $32.36 | $70.79 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $30.20 | Professional | None | $8.51 | $8.51 | $30.20 |
CareSource Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
CareSource Setting Professional Modifier None Typical Low $7.76 Median $15.14 Typical High $15.14 | Professional | None | $7.76 | $15.14 | $15.14 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $89.13 | Facility | None | $66.07 | $66.07 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $89.13 | Facility | None | $66.07 | $66.07 | $89.13 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $60.26 | Professional | None | $39.81 | $50.12 | $60.26 |
SummaCare Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $38.90 | Professional | None | $33.11 | $33.11 | $38.90 |
United Setting Professional Modifier None Typical Low $27.54 Median $30.90 Typical High $33.88 | Professional | None | $27.54 | $30.90 | $33.88 |
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 $15.49 | Professional | 52 · Reduced service | $14.45 | $14.45 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $6.17 | Professional | 53 · Discontinued | $5.75 | $5.75 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.57 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $3.09 |
Where Ohio sits
The same service costs 4.7 times more in Alaska than in Hawaii. 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· 42nd of 51
$30.20
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.