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 $34.67 Median $93.33 Typical High $295.12 | Facility | None | $34.67 | $93.33 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $38.02 | Professional | None | $33.88 | $33.88 | $38.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.90 Median $50.12 Typical High $95.50 | Facility | None | $30.90 | $50.12 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
Aultcare Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
CareSource Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
CareSource Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $27.54 | Professional | None | $20.42 | $20.42 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $74.13 Typical High $112.20 | Facility | None | $26.30 | $74.13 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | None | $33.88 | $33.88 | $39.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $26.30 Median $74.13 Typical High $97.72 | Facility | None | $26.30 | $74.13 | $97.72 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $41.69 | Professional | None | $33.88 | $33.88 | $41.69 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $31.62 Typical High $41.69 | Professional | None | $26.30 | $31.62 | $41.69 |
SummaCare Setting Professional Modifier None Typical Low $33.88 Median $35.48 Typical High $41.69 | Professional | None | $33.88 | $35.48 | $41.69 |
United Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
United Setting Professional Modifier None Typical Low $26.30 Median $30.20 Typical High $32.36 | Professional | None | $26.30 | $30.20 | $32.36 |
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 $16.98 Median $16.98 Typical High $18.62 | Professional | 52 · Reduced service | $16.98 | $16.98 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $7.59 | Professional | 53 · Discontinued | $6.76 | $6.76 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $5.62 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $3.72 |
Where Ohio sits
The same service costs 5.4 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· 26th of 51
$33.88
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.