How much rates vary
Facilitymedian $309 · 10th to 90th $178 to $575Professionalmedian $162 · 10th to 90th $162 to $251
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 $162.18 Median $446.68 Typical High $741.31 | Facility | None | $162.18 | $446.68 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $537.03 | Professional | None | $162.18 | $162.18 | $537.03 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $281.84 Typical High $501.19 | Facility | None | $177.83 | $281.84 | $501.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $239.88 | Professional | None | $162.18 | $162.18 | $239.88 |
Aultcare Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
CareSource Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $229.09 | Professional | None | $177.83 | $177.83 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $346.74 Typical High $524.81 | Facility | None | $169.82 | $346.74 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $213.80 | Professional | None | $162.18 | $162.18 | $213.80 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $169.82 Median $346.74 Typical High $489.78 | Facility | None | $169.82 | $346.74 | $489.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $363.08 | Professional | None | $162.18 | $162.18 | $363.08 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $218.78 | Professional | None | $162.18 | $186.21 | $218.78 |
SummaCare Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $251.19 | Professional | None | $169.82 | $194.98 | $251.19 |
United Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
United Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $199.53 | Professional | None | $162.18 | $181.97 | $199.53 |
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 $79.43 Median $79.43 Typical High $93.33 | Professional | 52 · Reduced service | $79.43 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $37.15 | Professional | 53 · Discontinued | $32.36 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $28.18 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $18.62 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $18.62 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $162.18 Median $177.83 Typical High $245.47 | Professional | JZ · No drug discarded | $162.18 | $177.83 | $245.47 |
Where Ohio sits
The same service costs 1.9 times more in Wyoming than in Nevada. 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· 45th of 51
$162
WY $302NV $162
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.