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 $52.48 Median $52.48 Typical High $457.09 | Facility | None | $52.48 | $52.48 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $158.49 | Professional | None | $52.48 | $52.48 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $117.49 | Professional | None | $44.67 | $52.48 | $117.49 |
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 $52.48 Median $52.48 Typical High $70.79 | Professional | None | $52.48 | $52.48 | $70.79 |
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 $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 $26.30 Median $26.30 Typical High $79.43 | Professional | 52 · Reduced service | $26.30 | $26.30 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $31.62 | Professional | 53 · Discontinued | $10.72 | $10.72 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $23.99 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $15.85 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $15.85 |
Where Ohio sits
The same service costs 18.6 times more in Wyoming than in Kentucky. 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· 45th of 51
$74.13
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.