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 $58.88 Median $144.54 Typical High $177.83 | Facility | None | $58.88 | $144.54 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $251.19 | Professional | None | $52.48 | $52.48 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $53.70 Median $85.11 Typical High $131.83 | Facility | None | $53.70 | $85.11 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $97.72 | Professional | None | $52.48 | $52.48 | $97.72 |
CareSource Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
CareSource Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $138.04 | Facility | None | $102.33 | $102.33 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $56.23 | Professional | None | $47.86 | $47.86 | $56.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $39.81 Median $102.33 Typical High $138.04 | Facility | None | $39.81 | $102.33 | $138.04 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $74.13 | Professional | None | $47.86 | $47.86 | $74.13 |
SummaCare Setting Professional Modifier None Typical Low $56.23 Median $58.88 Typical High $104.71 | Professional | None | $56.23 | $58.88 | $104.71 |
United Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
United Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $79.43 | Professional | None | $52.48 | $52.48 | $79.43 |
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 $26.30 Median $26.30 Typical High $125.89 | Professional | 52 · Reduced service | $26.30 | $26.30 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $50.12 | Professional | 53 · Discontinued | $10.72 | $10.72 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $38.02 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $25.12 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $25.12 |
Where Ohio sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 9th of 51
$63.10
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.