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 $70.79 Median $128.82 Typical High $186.21 | Facility | None | $70.79 | $128.82 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $117.49 Typical High $213.80 | Facility | None | $75.86 | $117.49 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $102.33 | Professional | None | $70.79 | $70.79 | $102.33 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $97.72 | Professional | None | $75.86 | $75.86 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $151.36 Typical High $234.42 | Facility | None | $74.13 | $151.36 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $100.00 | Professional | None | $70.79 | $70.79 | $100.00 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $74.13 Median $151.36 Typical High $208.93 | Facility | None | $74.13 | $151.36 | $208.93 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $100.00 | Professional | None | $70.79 | $70.79 | $100.00 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $81.28 Typical High $93.33 | Professional | None | $70.79 | $81.28 | $93.33 |
SummaCare Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $87.10 | Professional | None | $70.79 | $74.13 | $87.10 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier None Typical Low $67.61 Median $77.62 Typical High $83.18 | Professional | None | $67.61 | $77.62 | $83.18 |
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 $35.48 Median $35.48 Typical High $38.90 | Professional | 52 · Reduced service | $35.48 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $15.49 | Professional | 53 · Discontinued | $14.13 | $14.13 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $11.48 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.76 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | JZ · No drug discarded | $74.13 | $74.13 | $74.13 |
Where Ohio sits
The same service costs 1.5 times more in Wyoming than in Florida. 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· 41st of 51
$70.79
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.