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 $97.72 Median $97.72 Typical High $380.19 | Facility | None | $97.72 | $97.72 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $131.83 | Professional | None | $97.72 | $97.72 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $120.23 Typical High $131.83 | Facility | None | $87.10 | $120.23 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $151.36 | Professional | None | $83.18 | $97.72 | $151.36 |
CareSource Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
CareSource Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $131.83 | Professional | None | $97.72 | $97.72 | $131.83 |
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 $173.78 | Professional | None | $125.89 | $125.89 | $173.78 |
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 $173.78 | Professional | None | $125.89 | $125.89 | $173.78 |
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 $117.49 Median $125.89 Typical High $165.96 | Professional | None | $117.49 | $125.89 | $165.96 |
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 $48.98 Median $48.98 Typical High $66.07 | Professional | 52 · Reduced service | $48.98 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $26.30 | Professional | 53 · Discontinued | $19.50 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $19.50 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $13.18 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $13.18 |
Where Ohio sits
The same service costs 2.0 times more in Alaska than in North Carolina. 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· 40th of 51
$112
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.