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 $2.51 Median $2.51 Typical High $87.10 | Facility | None | $2.51 | $2.51 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $30.90 | Professional | None | $2.51 | $2.51 | $30.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.09 Median $2.51 Typical High $15.14 | Professional | None | $2.09 | $2.51 | $15.14 |
CareSource Setting Facility Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Facility | None | $2.51 | $2.51 | $2.51 |
CareSource Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $3.39 | Professional | None | $2.51 | $2.51 | $3.39 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $194.98 Typical High $389.05 | Facility | None | $125.89 | $194.98 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $316.23 | Facility | None | $125.89 | $177.83 | $316.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $131.83 | Professional | None | $79.43 | $97.72 | $131.83 |
SummaCare Setting Facility Modifier None Typical Low $134.90 Median $141.25 Typical High $158.49 | Facility | None | $134.90 | $141.25 | $158.49 |
SummaCare Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $151.36 | Professional | None | $109.65 | $123.03 | $151.36 |
United Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $151.36 | Professional | None | $109.65 | $125.89 | $151.36 |
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 $1.26 Median $1.26 Typical High $15.49 | Professional | 52 · Reduced service | $1.26 | $1.26 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.50 Typical High $6.17 | Professional | 53 · Discontinued | $0.50 | $0.50 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.37 Typical High $4.68 | Professional | 55 · Aftercare only | $0.37 | $0.37 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $3.09 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $3.09 |
Where Ohio sits
The same service costs 50.1 times more in Massachusetts than in Indiana. 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· 46th of 51
$4.07
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.