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 $33.88 Median $33.88 Typical High $72.44 | Facility | None | $33.88 | $33.88 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $36.31 | Professional | None | $33.88 | $33.88 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $33.88 Typical High $109.65 | Professional | None | $28.84 | $33.88 | $109.65 |
CareSource Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
CareSource Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $45.71 | Professional | None | $33.88 | $33.88 | $45.71 |
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 $87.10 Median $131.83 Typical High $186.21 | Professional | None | $87.10 | $131.83 | $186.21 |
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 $117.49 Median $125.89 Typical High $151.36 | Professional | None | $117.49 | $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 $16.98 Median $16.98 Typical High $18.20 | Professional | 52 · Reduced service | $16.98 | $16.98 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $7.41 | Professional | 53 · Discontinued | $6.76 | $6.76 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $5.50 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $3.63 |
Where Ohio sits
The same service costs 4.2 times more in North Dakota than in Maryland. 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· 34th of 51
$47.86
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.