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 $87.10 Median $87.10 Typical High $398.11 | Facility | None | $87.10 | $87.10 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $138.04 | Professional | None | $87.10 | $87.10 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $144.54 | Professional | None | $74.13 | $87.10 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
CareSource Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $117.49 | Professional | None | $87.10 | $87.10 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $275.42 Typical High $416.87 | Facility | None | $239.88 | $275.42 | $416.87 |
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 $239.88 Median $275.42 Typical High $363.08 | Facility | None | $239.88 | $275.42 | $363.08 |
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 $102.33 Typical High $131.83 | Professional | None | $87.10 | $102.33 | $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 $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 $43.65 Median $43.65 Typical High $69.18 | Professional | 52 · Reduced service | $43.65 | $43.65 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $27.54 | Professional | 53 · Discontinued | $17.78 | $17.78 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $20.89 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $13.80 |
Where Ohio sits
The same service costs 1.9 times more in Alaska than in New York. 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
$105
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.